两种途径中心静脉置管的对比观察

Clinical application of different approch for central venous catheterization

目的 :对比观察经颈内静脉和经锁骨下静脉穿刺置管的特点及并发症。 方法 :将 1 34例需行中心静脉置管病人分为两组 ,A组 (n =6 3)经颈内静脉穿刺置管 ,B组 (n =71 )经锁骨下静脉穿刺置管 ,均采用美国Arrow公司生产的一次性单腔中心静脉导管 ,观察 4周 ,比较两组的置管成功率、导管异位、导管堵塞、导管感染等并发症及病人的偏爱情况。 结果 :置管成功率、导管异位、导管堵塞、导管感染和血气胸 ,两组均无统计意义 (P <0 .0 5 )。病人明显偏爱锁骨下静脉置管 (P <0 .0 5 )。 结论 :经颈内静脉或锁骨下静脉行中心静脉置管 ,二者在置管特点和并发症上无明显差异 。

Objectives: To compare the catheterization success rate and complications of internal jugular venous access and subclavian venous access. Methods: 134 patients were assigned to two groups. Group A ( n =63) was via internal jugular vein and group B ( n =71) was via subclavian vein. All patients were applied with single lumen central venous catheters . After four weeks, the catheterization success rate, catheter translocation, catheter occlusion, catheter related sepsis, complications such as hemothorax and pneumothorax, and patients′ preferences were observed. Results: Overall catheterization success rates, catheter translocation,catheter occlusion ,catheter related sepsis, and other complications were not significantly different between two groups. Patients′ preference of 94.4% (67/71) for subclavian vein catheterization was significantly higher than 47.6% (30/63)for internal jugular venous access. Conclusions: The central venous catheterizations via internal jugular venous access and via subclavian venous access are safe in the same way. There were no significant difference in the catheterization success rate and complications. So we can select proper methods for central vein catheterization according to individual situation and patients′preference.