经胸前区腋静脉穿刺置管的临床探讨

Clinical study on intubation by anterior thoracic wall axillary venipuncture

目的 探讨经胸前区腋静脉穿刺置管的安全性及临床应用价值。方法 6 0 0例全身麻醉及硬膜外腔麻醉的手术病人 ,其中 5 5 0例行右侧腋静脉穿刺置管 ,5 0例行左侧腋静脉穿刺置管。结果 经胸前区腋静脉穿刺置管成功率为 99%。误穿腋动脉 2例 ,经局部压迫未造成血肿。结论 经胸前区腋静脉穿刺置管法 ,操作容易、成功率高、并发症少 ,为中心静脉穿刺提供新途径 ,值得在临床推广应用。

Objective To evaluate the reliability and clinical implement of intubation by anterior thoracic wall axillary venipuncture(IATAV).Methods Six hundred patients with general or epidural space anesthesia received IATAV,550 of them on the right side and the other 50 on the left side. Results IATAV was successful in 99% of the patients.The only complication was mistake stabbing of axillary artery in 2 cases,which did not cause hematom after local compression.There were no pneumothorax,hemothorax or brachial nerve injury.Conclusion IATAV is easy to do,highly successful and less complication.It is a feasible new method for central vein puncture.Clinical application broadly is warranty.