右侧锁骨下静脉置管相关问题的分析

Analysis of Problems Related to Right Subclavian Vein Catheterization

目的:探讨并分析右侧锁骨下静脉置管过程中所遇的问题。方法:选取泰州市第二人民医院2016年10月—2020年4月收治的200例应用经皮右侧锁骨下静脉置管患者的临床资料,并对其治疗过程中所遇的问题进行分析。结果:置管顺利,无任何并发症172例,置管失败4例,其中误入动脉2例,穿刺部位渗血、渗液15例,留置导管阻塞8例,导管脱落2例,导管相关性感染1例。结论:右侧锁骨下静脉置管作为中心静脉置管术的首选方式早已应用于临床,但仍存在置管失败、血气胸、留置导管内血栓形成、导管相关性感染等风险。熟练掌握该技术,熟悉各种并发症及相关问题的解决方案,才能更好地将此技术运用于广大患者。

Objective:To discuss and analyze the problems encountered in the catherization of right subclavian vein.Methods:The clinical data of 200 patients treated with percutaneous right subclavian vein catheterization in the hospital from October2016 to April 2020 were selected,and the problems encountered in the treatment process were analyzed.Results:The catheter was successfully placed without any complications in 172 cases.The catheter placement failed in 4 cases,including 2 cases of mistaken entry into the artery,15 cases of blood and fluid exudation at the puncture site,8 cases of obstruction of the indwelling catheter,2 cases of catheter detachment,and 1 case of catheter-related infection.Conclusion:Right subclavian vein catheterization has long been used clinically as the preferred method for central venous catheterization,but there are still risks such as catheter failure,hemopneumothorax,indwelling catheter thrombosis,and catheter-related infection.Only by mastering this technology and being familiar with the solutions of various complications and related problems can we better apply this technology to the majority of patients.