B超引导定位和体表定位在婴幼儿颈内静脉穿刺置管的对比分析

目的对比分析B超引导定位和体表定位在婴幼儿颈内静脉穿刺置管的应用。方法将60例需行颈内静脉置管的婴幼儿患者随机分为两组,每组30例:A组应用体表定位法行中心静脉置管,B组用B超引导定位行中心静脉置管。结果与A组相比,B组穿刺时间明显缩短(15.3±6.7s vs 33.6±8.2s),具有统计学差异,P<0.05;B组一次穿刺成功率(97%vs 83%)、置管成功率(97%vs 87%)均高于A组,具有统计学差异,P<0.05;B组穿入动脉低于A组(3%vs 17%),具有统计学差异,P<0.05。结论 B超引导定位可提高婴幼儿颈内静脉穿刺置管成功率,减少并发症的发生率。

A Prospective Comparison between to Ultrasound-Assisted Cannulation of the Internal Jugular Vein and the External Landmark-Guided Technique in infant patients

Objective To evaluate whether an ultrasound technique can improve on the traditional method in infant patients.Methods We prospectively evaluated an ultrasound-guided method in 30 patients undergoing internal jugular venous cannulation and compared the results with 30 patients in whom an external landmark-guided technique was used.Results Average access time（skin to vein） was 15.3±6.7 seconds by the ultrasound approach and 33.6±8.2 seconds by the landmark approach（P〈0.05）.The vein was entered on the first attempt in 97% of patients using ultrasound and in 83% using the landmark technique（P〈0.05）.Using ultrasound,puncture of the carotid artery occurred in 3% of patients.In the external landmark group,puncture of the carotid artery occurred in 17% of patients（P〈0.05）.Conclusions.Ultrasound-guided cannulation of the internal jugular vein significantly improves success rate,decreases access time,and reduces complication rate.These results suggest that this technique may be preferred in infant cases or when access problems are anticipated.