超声技术在颈内静脉穿刺置管中的应用.docVIP

超声技术在颈内静脉穿刺置管中的应用 【摘要】 目的：观察超声技术在颈内静脉穿刺置管中的应用。方法：选择ASAⅠ～Ⅱ级患者75例，随机分为三组，传统组（Ⅰ组）、超声定位组（Ⅱ组）、超声引导组（Ⅲ组），每组均为25例。观察各组穿刺操作的时间、患者穿刺一次成功的例数、穿刺次数及并发症发生例数。结果：一次穿刺成功率超声引导组为92.0%、超声定位组84.0%，明显高于传统组的60.0%，而且超声两组操作时间亦明显小于传统组，差异有统计学意义（P 0.05）。超声引导组患者穿刺相关并发症发生率为8.0%、超声定位组16.0%，显著低于传统组的44.0%，差异统计学意义（P 0.05）。结论：超声技术在颈内静脉穿刺是安全可行的技术，可极大提高穿刺成功率、缩短穿刺时间及减少并发症的发生，值得临床推广应用。 【关键词】 超声； 颈内静脉； 穿刺置管； 应用 【Abstract】 Objective： To observe the application of ultrasonic technique in internal jugular vein puncture tube. Method： 75 cases of ASAⅠ-Ⅱ patient were selected randomly and divided into three groups （25 cases a group）： conventional group （group I）， group of B-ultrasound localization （groupⅡ）， group of B-ultrasound guidance （group Ⅲ）. The time of puncture in the two groups， one-time successful puncture rates， puncture times and the complication rates were observed. Result： One-time successful puncture rates in group Ⅲ was 92.0%， and the rates in group Ⅱ was 84.0%. The rates in group Ⅱ and Ⅲ were significantly higher than 60.0% in convention group. And the time of puncture in group Ⅱ and Ⅲ were significantly less than group I. The comparison result had statistical significance （P 0.05）. The complication rates in group Ⅲ were 8.0% and 16.0% in group Ⅱ which were significantly less than 44.0% in group I. The comparison result had statistical significance （P 0.05）. Conclusion： The ultrasonic technique in internal jugular vein puncture tube is a highly-effective and safe technique to greatly improve the success rate of puncture， shorten the puncture time and reduce the complications which is worthy for extending in clinic. 【Key words】 Ultrasound； Internal jugular vein； Puncture tube； Application First-author’s address：Jiangmen Xinhui District Women’s Children’s Hospital of Guangdong Province， Jiangmen 529100，China doi：10.3969/j.issn.1674-4985.2015.09.045 在中心静脉压力的抢救、检测以及营养输液（长期）中，颈内静脉穿刺置管技术并不罕见。传统置管术需要通过体表解剖定位标志，是依靠解剖标志来判断静脉的位置进行经验性盲穿的，但解剖标志和静脉位置之间的关系常常存在变异，存在成功率低，并发症多缺点：在技术以及效果上可能无法仅通过定为予以穿刺；且患者可能存在需多