三种不同途径经皮深静脉置管术临床应用分析.pdfVIP

l Chn!~eGeneralPractice · 642 · 斓 · 短 篇 论 著 · 三种不同途径经皮深静脉置管术临床应用分析 胡 占升，于学江 【摘要】 目的 比较经锁骨下静脉、颈内静脉、股静脉3种不同途径深静脉穿刺置管的临床应用价值。方法 对本院重症监护病房收治的 180例患者按穿刺途径的不同分为3组：锁骨下静脉置管组 (s组，60例)、颈 内静脉置管 纽 (J组，60例)及股静脉置管纽 (G纽，6O例)。对比三种置管途径在首次穿刺失败率、导管置留时间以及相关并 发症等方面的差异。结果 导管留置时间、穿刺失败率、堵管、心律失常及血气胸的发生率由高至低依次为锁骨下静 脉置管、颈内静脉置管、股静脉置管，差异有统计学意义 (P0．01)。导管脱管、相关感染的发生率及清醒患者评价 舒适度由高至低依次为股静脉置管、颈内静脉置管、锁骨下静脉置管，差异有统计学意义 (P0．01)。结论 针对不 同病情的患者灵活选用穿刺途径，可有效减少深静脉穿刺的并发症。 【关键词】 锁骨下静脉；颈静脉；股静脉；静脉穿刺术 【中图分类号】R615 【文献标识码】B 【文章编号】1007—9572 (2010J02—0642—02 ClinicalApplicationofPereutaneousCatheterizationofDeepVeinthroughThreeDifferentChannels HUZhan—sheng， YUXue-jiang。IntensiveCareUnit，theAffiliatedHospitalofLiaoningMedicalCollege，Jinzhou121001，China A【bstract】 Objective Toexploretheclinicalapplicationofpercutaneouscatheterizationofdeepveinthroughthree differentchannels．Methods Totally180 [CUpatientswererandomlydividedinto3groups，inwhichpercutaneouscatheteriza— tionwasperformedthroughsubclavianvein，internaljugularvein，orfemoralvein，respectively．Thefailurerateofthefirstveni— punctureattempt，timeofindwellingcatheters，andcatheter—relatedcomplicationswererecordedwhenusingthethreedifferent ways．Results Thetimeofindwellingcatheter，venipuncturefailurerate，incidenceoftubeblockage，andincidencesofar- rhythmiaandhemopneumothoraxwerehighestinsubclavianveingroup，followedbyinternaljugularveingroup，andlowestin femoralveingroup(P0．01)．Theincidenceofcatheterslippage，incidenceofinfections，anddegreeofcomfort(evaluated bytheawakepatients)werebestinthefemoralveingroup，followedbyinternaljugularveingroupandsubclavianvein group．Conclusion Puncturechannelscanbeselectivelyusedbasedonthepatients specificconditions，SOastominimizedeep veinpuncture