颈外静脉、颈内静脉和锁骨下静脉穿刺的比较

目的 探讨中心静脉置管的较佳途径.方法 将90例需行中心静脉置管手术病人随机分为3组,每组30例.颈外静脉穿刺置管组(E组),颈内静脉穿刺置管组(Ⅰ组),锁骨下静脉穿刺组(S组),记录首次成功率、2次成功率、总穿刺置管成功率、穿刺完成时间、置管完成时间、并发症发生情况.结果 E组穿刺置管的穿刺完成时间比Ⅰ组和S组穿刺要短(P＜0.01)、并发症少(P＜0.05).E组穿刺和Ⅰ组穿刺比S组穿刺的置管完成时间长(P＜0.01).三种穿刺的首次成功率、2次成功率、总成功率无差异(P＞0.05).结论 颈外静脉穿刺置管具有操作简便、穿刺完成时间短、并发症少等优点,与颈内静脉和锁骨下静脉穿刺置管比较,是一种更为安全实用的中心静脉置管方法.

Comparison of puncture and catheter-placement in external, internal jugular and subclavian vein

Objective To explore the best way to the catheter -placement in the central vein.Methods 90 patients were randomly divided into three groups:internal jugular vein group (I group,n=30);subclavian vein group (S group,n=30);external jugular vein group (E group,n=30).All patients of three groups were performed puncture and catheter-placement respectively in the external,internal jugular and subclavian vein.Success rate at the first time,success rate at the second time,total success rate,and puncture time,catheterization time,complication incidence were recorded.Results Shorter puncture time(P<0.01)and less complication(P<0.05)were found in those who were performed puncture and catheter-placement in the E group compared with I group and S group.The catheterization time was longer in I group and E group than S group.There were no difference of total success rate, success rate at the first time, success rate at the second time in three groups.Conclusion Puncture and catheter-placement in the external jugular vein is a best way applied to the catheter-placement in the central vein.