超声引导下短轴法与长轴法在新生儿颈内静脉置管中的比较

Comparison of short-axis and long-axis approaches in neonatal internal jugular vein catheterization under ultrasound guidance

目的:探讨超声引导下短轴法与长轴法在新生儿颈内静脉置管中的应用效果。方法:回顾性分析2018年1月—2021年12月在汕头大学医学院第二附属医院新生儿科住院并行超声引导下颈内静脉穿刺置管术的69例患儿的临床资料。按照穿刺方式分为短轴组(34例)和长轴组(35例)。比较两组穿刺置管的术前准备时间、首次穿刺成功时间、穿刺血管次数、穿刺总耗时以及并发症发生率。结果:短轴组与长轴组颈内静脉置管术前准备时间分别为1 (1,1)、6 (5,8)min,首次穿刺成功时间分别为3 (2,4)、5 (3,7) min,穿刺总耗时分别为17.50 (13.75,19.95)、21.00 (15.00,24.00) min,短轴组颈内静脉置管的术前准备时间、首次穿刺成功时间和穿刺总耗时均短于长轴组,差异具有统计学意义(P值均<0.05)。短轴组与长轴组穿刺血管次数、并发症发生率差异无统计学意义(P值均>0.05)。结论:超声引导下短轴法比长轴法在新生儿颈内静脉置管中操作更快速、便捷。

Objective: To investigate the application effect of ultrasound-guided short-axis and long-axis approaches in neonatal internal jugular vein catheterization. Methods: The clinical data of 69 neonates who underwent ultrasound-guided internal jugular vein puncture and catheterization in the Department of Neonatology, the Second Affiliated Hospital of Shantou University Medical College from January 2018 to December 2021 were retrospectively analyzed. According to the puncture method, they were divided into short-axis group(34 cases) and long-axis group(35 cases). The preoperative preparation time, the first successful puncture time, the times of puncturing the blood vessels, the total time of puncture and the incidence of complications were compared between the two groups. Results: The preparation time before internal jugular vein catheterization in the short-axis group and the long-axis group were 1(1, 1) minute and 6(5, 8) minutes,respectively, and the first successful puncture time was 3(2, 4) minutes and 5(3, 7) minutes, the total puncture time was 17.50(13.75, 19.95) minutes, 21.00(15.00, 24.00) minutes, respectively. The preoperative preparation time, the first successful puncture time and the total puncture time of the internal jugular vein catheterization in the short-axis group were shorter than the long-axis group, and the difference was statistically significant(all P<0.05). There was no significant difference in the number of puncture vessels and the incidence of complications between the short-axis group and the long-axis group(all P>0.05). Conclusion: Ultrasound-guided short-axis approach is faster and more convenient than long-axis approach in neonatal internal jugular vein catheterization.