持续唱高音法对颈内静脉横截面积及颈内静脉穿刺置管术效果的影响

Effects of keeping singing high notes on cross-sectional area of internal jugular vein and efficacy of internal jugular vein puncture and catheterization

目的探讨持续唱高音法对颈内静脉横截面积和颈内静脉穿刺置管术效果的影响。方法将60例行颈内静脉穿刺置管术的患者分成A组和B组,每组30例。两组患者进入手术室后均分别在平静呼吸和持续唱高音时采用B超测量颈内静脉横截面积和有效穿刺长度,A组患者在持续唱高音时进行颈内静脉穿刺置管术,B组根据传统解剖学标志进行颈内静脉穿刺置管术。比较所有患者平静呼吸时与持续唱高音时的颈内静脉横截面积和有效穿刺长度,以及两组患者首次穿刺成功率、穿刺总成功率、穿刺时间及穿刺置管并发症发生率。结果所有患者持续唱高音时颈内静脉横截面积和有效穿刺长度均高于平静自主呼吸时(均P<0.05);A组首次穿刺成功率高于B组、穿刺时间均短于B组(均P<0.05),但两组穿刺总成功率和穿刺并发症发生率差异均无统计学意义(均P>0.05)。结论持续唱高音法可增加颈内静脉横截面积和有效穿刺长度,有利于颈内静脉穿刺置管。

Objective To investigate the effects of keeping singing high notes on the cross-sectional area of the internal jugular vein as well as the efficacy of the internal jugular vein puncture and catheterization.Methods Sixty patients undergoing the internal jugular vein puncture and catheterization were divided into group A and group B,with 30 cases in each group.The cross-sectional area and effective puncture length of the internal jugular vein were measured by B-mode ultrasound in the state of eupnea and at the time of keeping singing high notes,respectively,in both groups after entering the operating room.Patients in group A received the internal jugular vein puncture and catheterization when kept singing high notes,group B underwent the internal jugular vein puncture and catheterization based on the conventional anatomical markers.The cross-sectional area and effective puncture length of the internal jugular vein were compared between patients in the state of eupnea and at the time of keeping singing high notes,and the success rate of initial puncture,total success rate of punctures,puncture duration,and incidence rate of complications associated with puncture and catheterization were compared between the two groups as well.Results In all patients the internal jugular vein cross-sectional area and effective puncture length at the time of keeping singing high notes were higher than those in the state of spontaneous eupnea(all P<0.05);group A had higher success rate of initial puncture and shorter puncture duration than group B(all P<0.05),however,there was no statistically significant difference in total success rate of punctures or incidence rate of puncture-related complications between the two groups(all P>0.05).Conclusion Keeping singing high notes can increase the cross-sectional area and effective puncture length of the internal jugular vein,and is conducive to the internal jugular vein puncture and catheterization.