颈外静脉与四肢浅静脉留置针在院前急救中的效果比较

目的 探讨颈外静脉与四肢浅静脉留置针在院前急救中的应用效果，以迅速建立静脉通路，并为后续治疗提供最佳输液途径。方法 将140例危重患者随机分为对照组和观察组各70例，对照组行四肢浅静脉留置针输液，观察组采用颈外静脉留置针输液。结果 观察组能快速建立静脉通道，易固定，穿刺时间短，穿刺成功率高，与对照组比较，差异有显著性意义（P〈0．01）。结论 颈外静脉留置针在院前急救中能快速建立静脉通道，输液效果好。     

颈外静脉留置针穿刺在创伤性失血性休克病人抢救中的应用

目的探讨颈外静脉留置针在严重创伤性失血性休克患者护理中的应用。方法将收治创伤性失血性休克患者116例,其中56例采用颈外静脉留置针穿刺,60例采用四肢浅静脉留置针穿刺,现将两种静脉留置针穿刺方法进行分析比较。结果颈外静脉组在一次穿刺成功率、穿刺所需时间、导管脱出、留置时间等,均比四肢静脉组有更好的临床效果,2组比较有显著性差异(PO.01)。结论静脉通道的建立在抢救过程中尤为重要。在实施失血性休克病人抢救输液操作时,应根据其血管的具体情况采取相应有效的方法,提高静脉穿刺成功率。     

颈外静脉穿刺置管在大量输液中的应用

目的 探讨颈外静脉穿刺置管用于大量输液患者的效果,以寻找最佳输液途径.方法 将需大量输液(每日补液量≥2 500 ml)的100例患者随机分为观察组和对照组各50例,观察组采用颈外静脉留置针输液,对照组采用四肢浅静脉留置针输液.结果 两组患者一次置管成功率比较,差异无显著性意义(P＞0.05);两组平均留置时间,导管脱落、导管堵塞、液体渗漏、静脉炎、补钾疼痛的发生率比较,差异有显著性意义(P＜0.05,P＜0.01).结论 颈外静脉穿刺置管用于大量输液,可减少静脉置管并发症,且可延长留置时间.     

颈外静脉留置针穿刺置管在危重患者抢救中的应用

目的:提高危重患者静脉输液质量。方法:将200例危重患者随机分为观察组和对照组各100例。采用22G静脉留置针,观察组行颈外静脉穿刺置管,对照组行四肢浅表静脉穿刺置管。观察两组留置针穿刺效果和留置效果。结果:观察组一次穿刺成功率及留置时间显著高于对照组(均P<0.01),静脉置管异常情况发生率显著低于对照组(P<0.01)。结论:应用颈外静脉留置针穿刺置管能有效提高危重患者静脉输液护理质量,有利于患者的救治。     

颈外静脉留置针通道在上消化道大出血患者输液中的应用

目的 提高上消化道大出血患者静脉输液护理质量.方法 将64例上消化道大出血患者随机分为观察组和对照组各32例.采用22 G静脉留置针,观察组行颈外静脉穿刺置管.对照组行前臂静脉穿刺置管.观察两组留置针穿刺效果和留置效果.结果 观察组一次穿刺成功率及经留置针采血成功率显著高于对照组(均P＜0.01),穿刺时间显著短于对照组(P＜0.01),留置时间显著长于对照组(P＜0.01),外渗及并发症总发生率显著低于对照组(P＜0.05,P＜0.01),单通道1 h液体补充量显著多于对照组(P＜0.01).结论 应用颈外静脉留置针通道能有效提高上消化道大出血患者静脉输液护理质量,有利于患者的救治.     

颈外静脉穿刺置管在大量输液中的应用

目的探讨颈外静脉穿刺置管用于大量输液患者的效果，以寻找最佳输液途径。方法将需大量输液（每日补液量≥2500m1）的100例患者随机分为观察组和对照组各50例，观察组采用颈外静脉留置针输液，对照组采用四肢浅静脉留置针输液。结果两组患者一次置管成功率比较，差异无显著性意义（P〉0．05）；两组平均留置时间，导管脱落、导管堵塞、液体渗漏、静脉炎、补钾疼痛的发生率比较，差异有显著性意义（P〈0．05，P〈0．01）。结论颈外静脉穿刺置管用于大量输液，可减少静脉置管并发症，且可延长留置时间。     

CCU患者使用浅静脉留置输液的体会

目的:讨论CCU患者使用浅静脉留置针的益处.方法:选取2007年6月～2010年6月收治于我科的患者532例,随机选择268例患者使用浅静脉留置针输液,另264人使用普通金属头皮针输液,以此进行对比分析.结果:浅静脉留置针输液优于普通金属头皮针输液.结论:浅静脉留置针因留置时间长,不需反复穿刺以减轻患者的痛苦及减少护士的工作量,并方便了为患者急救时迅速建立静脉通道.     

上消化道出血患者颈外静脉留置针穿刺方法的改进

目的 探讨提高上消化道出血患者颈外静脉留置针穿刺成功率的最佳方法.方法 将100例上消化道出血患者按住院单双日分为观察组和对照组各50例.观察组采用改进的颈外静脉穿刺法,即按照解剖部位垂直盲穿进针;对照组按照传统穿刺方法.观察两组一次穿刺成功率及穿刺成功所需时间.结果 观察组一次穿刺成功率显著高于对照组,穿刺时间显著短于对照组(均P＜0.01).结论 应用改良后的颈外静脉留置针穿刺法能缩短穿刺时间,提高穿刺成功率,有利于上消化道出血患者的救治.     

早产儿腋下浅静脉留置针置管及护理

目的:探讨早产儿腋下静脉留置针穿刺的效果及护理。方法:早产儿50例随机分为观察组和对照组各50例,观察组留置针置于患儿腋下静脉,对照组留置针置于患儿四肢静脉,比较两个部位留置时间的长短及静脉炎的发生率。结果:观察组留置时间与对照组比较,差异有统计学意义(P<0.05),静脉炎发生率低于对照组,差异有统计学意义(P<0.05)。结论:早产儿腋下静脉留置针的效果好于四肢静脉留置。     

头皮静脉留置针不同穿刺部位留置时间比较

目的探讨小儿头皮留置针不同穿刺部位的留置时间。方法将200例小儿肺炎患儿随机分成四组各50例,分别采取额前中静脉、眶上静脉、颞浅静脉和耳后静脉进行留置针穿刺输液,按照常规输液护理,比较其留置时间。结果额前中静脉组、颞浅静脉组留置时间显著长于眶上静脉组和耳后静脉组。结论额前中静脉和颞浅静脉比较适合小儿头皮留置针穿刺。     

Long-term Results of Vein Sparing Varicose Vein Surgery

The aim of this study was to assess the long-term functional outcome of vein sparing varicose vein surgery using handheld Doppler ultrasound (HHD). The series consisted of 171 consecutive day-case surgery patients operated on for uncomplicated lower limb varicose veins. Venous segments considered competent were spared based on clinical examination and HHD, which was performed preoperatively only when deemed necessary by the surgeon. After a mean follow-up of 8 years all patients were examined, a systematic HHD evaluation was performed, and the findings were classified according to the CEAP (Clinical, Etiological, Anatomical, Pathophysiological) classification, and disability scoring was performed. During the follow-up period 17% of the legs were reoperated or scheduled for reoperation. At follow-up 79% of all patients were asymptomatic without reoperation. In 24%, recurrent varicosities were present and venous reflux was demonstrated by HHD. Recurrence was two times more common when the saphenofemoral junction had originally been left intact. Of all recurrent cases, reflux was demonstrated in the long saphenous vein (LSV) above the knee in 62%, in the LSV below the knee in 7%, in the short saphenous vein (SSV) in 16%, in the posterior arch vein in 38%, and in a thigh perforator in 8%. Of the legs reoperated during the follow-up period 41% presented with venous reflux at the follow-up visit. We conclude that HHD efficiently reveals sites of reflux that have been missed during previous surgery and that a thorough preoperative HHD examination and marking of reflux routes is required.     

Great Mediastinal Vein Reconstruction Using Autologous Superficial Femoral Vein Superficial Femoral Vein Graft

Abstract Background and Aim: Great mediastinal veins may be reconstructed using autologous, synthetic, or allograft conduits. Autologous conduits have been found superior to other conduit options. The superficial femoral vein (SFV) offers excellent early patency, minimal lower limb morbidity, and ease of harvest without accessory suture lines. Although rarely used, the SFV provides an acceptable alternative for conduit in large vein reconstructions. Methods: Two recent cases using SFV for great mediastinal vein reconstruction were reviewed and operative technique of vein harvest detailed. Results: This is the first report of successful reconstruction of a left superior vena cava using SFV conduit. Both superior vena cava (SVC) reconstructions reported were perfectly patent at intermediate term follow‐up (20 and 14 months) as determined by computed tomography angiogram or magnetic resonance imaging. Conclusions: Successful and durable reconstruction of the SVC or a persistent left subclavian vein is possible with minimal morbidity using the SFV.     

Internal Jugular Vein Occlusion Test for Rapid Diagnosis of Misplaced Subclavian Vein Catheter into the Internal Jugular Vein

Background : During subclavian vein catheterization, the most common misplacement of the catheter is cephalad, into the ipsilateral internal jugular vein (IJV). This can be detected by chest radiography. However, after any repositioning of the catheter, subsequent chest radiography is required. In an effort to simplify the detection of a misplaced subclavian vein catheter, the authors assessed a previously published detection method.

Methods : One hundred adult patients scheduled for subclavian vein cannulation were included in this study. After placement of subclavian vein catheter, chest radiography was performed. While the x-ray film was being processed, the authors performed an IJV occlusion test by applying external pressure on the IJV for approximately 10 s in the supraclavicular area and observed the change in central venous pressure and its waveform pattern. The observations thus obtained were compared with the position of catheter in chest radiographs, and the sensitivity and specificity of this method were evaluated using a 2 x 2 table.

Results : In 96 patients, subclavian vein cannulation was successfully performed. In four patients, cannulation was unsuccessful; therefore, these patients were excluded from the study. There were six misplacements of venous catheters as detected by radiography. In five (5.2%) patients, the catheter tip was located in the ipsilateral IJV, and in one (1.02%), the catheter tip was located in the contralateral subclavian vein. In the patients who had a misplaced catheter into the IJV, IJV occlusion test results were positive, with an increase of 3-5 mmHg in central venous pressure, whereas the test results were negative in patients who had normally placed catheters or misplacement of a catheter other than in the IJV. There were no false-positive or false-negative test results.     

Early Morphology of Accelerated Vein Graft Atheroma in Experimental Vein Grafts

n = 3 per time point) were sacrificed at 60 min, 1 day, 3 days, 5 days, 7 days, 14 days, and 28 days postoperatively for scanning and transmission electron microscopy of the vein grafts. No concurrent controls were employed. The results of this study suggest that in the presence of hypercholesterolemia, the pathophysiological processes involved in the vein graft are similar to those reported for noncholesterol-fed animals. There is a sustained subendothelial response with the prolonged presence of macrophages and cellular debris and the accumulation of foam cells.