B超引导后路颈内穿刺在输液港置入中的应用

Application of B-ultrasound-guided posterior internal jugular vein catheterization in infusion port

目的 探讨B超引导下经后路颈内静脉穿刺置管行输液港置入手术在临床中的应用与效果。方法 选取2020年3月至2021年12月在湖州市中心医院拟行完全植入式静脉输液港(totally implantable venous access port,TIVAP)手术的患者84例,随机分为三组:A组(n=28)在B超引导下经后路颈内静脉穿刺置入TIVAP;B组(n=28)同A组但改行中路颈内静脉穿刺置入TIVAP;C组(n=28)采用盲穿法行中路颈内静脉穿刺置入TIVAP。所有患者的操作均由同一医疗组技术熟练经验丰富的外科医生完成。记录颈内静脉一次性穿刺成功率、手术并发症发生率、手术操作时间等指标。结果 颈内静脉穿刺置入TIVAP手术操作过程中采用B超引导较盲穿法一次性穿刺成功率高,手术时间短,且手术并发症少,差异有统计学意义(P<0.05);后路较中路手术用时短,差异有统计学意义(P<0.05)。结论 B超引导下后路颈内静脉穿刺置入TIVAP具有操作简便、安全性高、并发症少等优点,且易于初学者学习掌握,是一种有效且实用的颈内置管方法。

Objective To explore the clinical application and effect of B-ultrasound-guided posterior internal jugular vein catheterization in infusion port.Methods A total of 84 patients with totally implantable venous access port(TIVAP)in Huzhou Central Hospital were randomly divided into three groups from March 2020 to December 2021.Group A(n=28)was placed in the infusion port through posterior internal jugular vein puncture under the guidance of B-ultrasound,while group B(n=28)was the same as group A,but changed to middle internal jugular vein puncture and port placement,In group C(n=28),the middle internal jugular vein puncture was performed by blind puncture.All patients were completed by experienced surgeons in the same medical group.The success rate of one-time internal jugular vein puncture,the incidence of surgical complications and the operation time were recorded.Results Compared with blind puncture,the one-time puncture success rate of internal jugular vein puncture under the guidance of B-ultrasound was higher,the operation time was shorter,and the complications were less,and the difference was statistically significant(P<0.05).The operation time of posterior approach was shorter than that of middle approach,and the difference was statistically significant(P<0.05).Conclusion B-ultrasound-guided posterior internal jugular vein catheterization is an effective and practical method for cervical catheterization with simple operation,high safety,few complications and easy for beginners to learn and master.