基于全麻下不同径路行右颈内静脉穿刺置管术的临床效果研究.docVIP

基于全麻下不同径路行右颈内静脉穿刺置管术的临床效果研究 　　[摘要] 目的 探讨基于全麻下经胸锁乳突肌三角中路与颈动脉旁前路行右颈内静脉穿刺术的临床效果。 方法 随机选取2004年9月～2014年9月本院收治的全身麻醉患者100例，均行基于全麻下右颈内静脉穿刺置管术，分为经颈动脉旁前路穿刺置管组50例，经胸锁乳突肌三角中路穿刺置管组50例，对比分析两组患者的成功率和不良反应发生率。 结果 经颈动脉旁前路穿刺置管组成功48例（96%），失败2例（4%），经胸锁乳突肌三角中路穿刺置管组成功40例（80%），失败10例（20%），差异有统计学意义（P0.05）；误穿动脉2例（4%），明显少于经胸锁乳突肌三角中路穿刺置管组12例（24%），差异有统计学意义（P0.05）。 结论 基于全麻下右颈内静脉穿刺置管术，经颈动脉旁前路置管的效果更为显著，安全性更高，值得临床推广应用。 　　[关键词] 全身麻醉；右颈内静脉置管术；临床效果；颈动脉；胸锁乳突肌三角 　　[中图分类号] R614.2+4 [文献标识码] A [文章编号] 1674-4721（2015）07（b）-0096-03 　　[Abstract] Objective To explore the different clinical effects of right internal jugular vein catheterization by medium pathway of triangle in sternocleidomastoid and anterior side of carotid artery under general anesthesia. Methods From September 2004 to September 2014，100 patients accepted general anesthesia in our hospital were randomly selected.They were provided with right internal jugular vein catheterization，and evenly divided into anterior side of carotid artery catheterization group（n=50） and medium pathway catheterization of triangle in sternocleidomastoid group（n=50）.The success rate and incidence of adverse reaction between two groups were comparatively analyzed. Results There were 48 cases in success anterior side of carotid artery catheterization group， accounting for 96%.Only 2 cases were in failure.In the medium pathway catheterization of triangle in sternocleidomastoid group，40 cases were successful，accounting for 80%，10 cases were failure，accounting for 20% with statistical difference（P0.05）.There were two cases puncturing into artery mistakenly in 4%，greatly lower than that in the medium pathway catheterization of triangle in sternocleidomastoid group，accounting for 24%（n=12），with statistical difference （P0.05）. Conclusion Right internal jugular vein catheterization under general anesthesia can obtain a more remarkable effect and higher safety by anterior side of carotid artery catheterization，which is worthy of application and expansion in clinical.