高频超声定位在失血性休克患者颈内静脉穿刺置管中的应用

目的探讨高频超声定位在失血性休克患者颈内静脉穿刺置管中的有效性和安全性。方法选择101例急诊失血性休克患者,按随机数字表法分为观察组和对照组,分别在高频超声定位和体表定位下行右颈内静脉穿刺置管,记录两组患者穿刺一次成功率、穿刺置管时间以及误穿动脉、血肿、气胸等并发症发生率。结果对照组穿刺一次成功率为75.0%,观察组为91.8%,观察组明显高于对照组（P〈0.05）;对照组穿刺置管时间为（267±37）s,观察组为（216±33）s,观察组显著短于对照组（P〈0.05）;对照组有8例误穿颈内动脉,观察组无一例误穿动脉（P〈0.05）。结论高频超声定位下对失血性休克患者行颈内静脉穿刺置管一次成功率高,穿刺时间短,并发症少,优于体表定位下的穿刺置管。

Application of High-frequency Ultrasound Localization in Internal Jugular Vein Catheterization in Patients with Hemorrhagic Shock

Objective To evaluate the efficiency and safety of high-frequency ultrasound localization in internal jugular vein catheterization in patients with hemorrhagic shock.Methods A total of 101 emergency patients with hemorrhagic shock undergoing internal jugular vein catheterization were randomized prospectively into two groups：the ultrasound guided group（observational group） and the anatomic landmarks guided group（control group）.The one-time success rate,the time of the catheterization and the incidence of complications of inadvertent arterial miss,hematoma,pneumothorax of the two groups were recorded.Results The one-time success rate was significantly higher in the observational group（91.8%） than that in the control group（75.0%）（P〈0.05）.The time of the catheterization was significantly less in the observational group（267±37）s than that in the control group（216±33）s （P〈0.05）.Inadverntent arterial miss was observed in 8 cases of the control group,but none in the observational group（P〈0.05）.Conclusion High-frequency ultrasound localization in internal jugular vein catheterization improves the one-time success rate,shorten the time of catheterization,decreases the incidence of complications,with the superior effect compared with the anatomic landmarks technique in patients with hemorrhagic shock.