中心静脉穿刺置管在大面积烧伤治疗中的应用

对我院近年来收治的大面积烧伤患者进行回顾性病历资料统计。结果发现108例患者应用中心静脉穿刺置管,其中98例(90.7％)经股静脉入路;7例(6.4％)经右锁骨下静脉,3例(3％)经颈内静脉。2例发生气胸,需行胸腔闭式引流。提示中心静脉穿刺置管应用于烧伤病人方便抢救和治疗,但医生和护理人员一定要充分了解其并发症,并且重视一些严重并发症如血管损伤致出血、胸膜损伤致气胸、以及心包填塞、气体栓塞等的预防、诊断和处理。

Treatment of extensive area burned patients by ceneral venous catheterizations

Central venous catheterizations were used in one hundred and eight extensive area burned patientsduring recently five years in Shandong Provincial Hospital according to the data from retrospective chartreview. Ninty-eight (90.7%)catheters were inserted into the femoral vein, seven (6.4%)into the right subclavianvein and three (3%) into the internal jugular vein. There were two coses of pneumothorax reported requiringclosely drainage,and all occurred with subclavian access. There were no long-term sequelae or life-threatening orlimb-threatening complications. It is concluded that central venous catheterization,particularly using the femoralapproach, appears to a safe and effective method in the extensive area burn patients: realization and properlymanagement of catheter related complications remain great challenge. Inherent risks of central venous cathetersare intrinsic and should be discussed with the family in obtaining preoperative consent,including life-threateningrisks that may necessitate urgent surgical intervention (by thoracotomy or other means).