Objective: To clarify the role of the “Three Threes” method in clinical teaching of internal jugular vein puncture and explore improvements in teaching methods. Methods: A doctor was assigned to the induction room o...Objective: To clarify the role of the “Three Threes” method in clinical teaching of internal jugular vein puncture and explore improvements in teaching methods. Methods: A doctor was assigned to the induction room of the Second Affiliated Hospital of Naval Medical University (Shanghai Changzheng Hospital) for two months. The time required for catheterization, the first puncture success rate, and occurrence of puncture-related complications were compared before and after learning the “Three Threes” method. Results: Using the “Three Threes” method reduced the catheterization time by 43%, increased the first puncture success rate by 17%, and led to fewer puncture-related complications. Conclusion: The application of the “Three Threes” method not only improves the success rate of internal jugular vein puncture but also reduces complications, making it easier for students to master the technique.展开更多
Central vein catheter （CVC） placement, which is widely utilized in clinical departments, is also highly important in preoperative preparations for radiofrequency catheter ablation （RFCA）. The internal jugular vein...Central vein catheter （CVC） placement, which is widely utilized in clinical departments, is also highly important in preoperative preparations for radiofrequency catheter ablation （RFCA）. The internal jugular vein or subclavian vein is the routine target. Arterial injury is not uncommon during the procedure but is potentially devastating in spite of the safety and advantages of the Seldinger technique. Compressing of the airway by a hematoma, as well as hemothorax, pseudoaneurysm, arteriovenous fistula, stroke, and even death, has been well-described.展开更多
目的探讨超声引导下右侧颈内静脉穿刺术在肾衰竭患者血液透析中应用价值。方法随机选择116例肾衰竭患者,其中男性79例,女性37例;年龄35～62岁,平均年龄54.54岁。根据不同穿刺方法分为对照组(58例)和观察组(58例)。对照组男性39例,女性19...目的探讨超声引导下右侧颈内静脉穿刺术在肾衰竭患者血液透析中应用价值。方法随机选择116例肾衰竭患者,其中男性79例,女性37例;年龄35～62岁,平均年龄54.54岁。根据不同穿刺方法分为对照组(58例)和观察组(58例)。对照组男性39例,女性19例;年龄35～62岁,平均年龄53.43岁。观察组男性40例,女性18例;年龄36～61岁,平均年龄54.86岁。对照组采用盲法定位法,观察组采用超声引导穿刺,比较两组患者置管情况(术中穿刺置管成功率、置管时间和置管成功率)。比较两组置管感染情况、舒适度评分和并发症发生情况。结果观察组第1次穿刺成功率明显高于对照组(97%vs 71%;χ~2=12.889,P <0.01),置管时间短于对照组[(7.16±0.99) min vs (11.75±1.54) min](t=19.094, P <0.01)。对照组术后感染患者多于观察组(6.9%vs 1.7%;χ~2=5.902,P <0.05)。对照组误伤颈动脉6例,神经损伤4例,局部血管气肿5例,血胸、气胸4例;观察组局部血管气肿1例。对照组发生误伤颈动脉、神经损伤和血胸、气胸发生率显著高于观察组(χ~2=6.327、4.143、4.143,P <0.05)。对照组舒适度评分显著低于观察组[(66.43±6.43)分vs (84.32±8.43)分](t=-12.851,P <0.05)。结论在肾衰竭患者血液透析中采用超声引导下右侧颈内静脉穿刺术可提高置管成功率,减少感染和并发症发生,具有高的临床应用价值。展开更多
文摘Objective: To clarify the role of the “Three Threes” method in clinical teaching of internal jugular vein puncture and explore improvements in teaching methods. Methods: A doctor was assigned to the induction room of the Second Affiliated Hospital of Naval Medical University (Shanghai Changzheng Hospital) for two months. The time required for catheterization, the first puncture success rate, and occurrence of puncture-related complications were compared before and after learning the “Three Threes” method. Results: Using the “Three Threes” method reduced the catheterization time by 43%, increased the first puncture success rate by 17%, and led to fewer puncture-related complications. Conclusion: The application of the “Three Threes” method not only improves the success rate of internal jugular vein puncture but also reduces complications, making it easier for students to master the technique.
文摘Central vein catheter （CVC） placement, which is widely utilized in clinical departments, is also highly important in preoperative preparations for radiofrequency catheter ablation （RFCA）. The internal jugular vein or subclavian vein is the routine target. Arterial injury is not uncommon during the procedure but is potentially devastating in spite of the safety and advantages of the Seldinger technique. Compressing of the airway by a hematoma, as well as hemothorax, pseudoaneurysm, arteriovenous fistula, stroke, and even death, has been well-described.
文摘目的探讨超声引导下右侧颈内静脉穿刺术在肾衰竭患者血液透析中应用价值。方法随机选择116例肾衰竭患者,其中男性79例,女性37例;年龄35～62岁,平均年龄54.54岁。根据不同穿刺方法分为对照组(58例)和观察组(58例)。对照组男性39例,女性19例;年龄35～62岁,平均年龄53.43岁。观察组男性40例,女性18例;年龄36～61岁,平均年龄54.86岁。对照组采用盲法定位法,观察组采用超声引导穿刺,比较两组患者置管情况(术中穿刺置管成功率、置管时间和置管成功率)。比较两组置管感染情况、舒适度评分和并发症发生情况。结果观察组第1次穿刺成功率明显高于对照组(97%vs 71%;χ~2=12.889,P <0.01),置管时间短于对照组[(7.16±0.99) min vs (11.75±1.54) min](t=19.094, P <0.01)。对照组术后感染患者多于观察组(6.9%vs 1.7%;χ~2=5.902,P <0.05)。对照组误伤颈动脉6例,神经损伤4例,局部血管气肿5例,血胸、气胸4例;观察组局部血管气肿1例。对照组发生误伤颈动脉、神经损伤和血胸、气胸发生率显著高于观察组(χ~2=6.327、4.143、4.143,P <0.05)。对照组舒适度评分显著低于观察组[(66.43±6.43)分vs (84.32±8.43)分](t=-12.851,P <0.05)。结论在肾衰竭患者血液透析中采用超声引导下右侧颈内静脉穿刺术可提高置管成功率,减少感染和并发症发生,具有高的临床应用价值。
