锁骨下静脉穿刺置管术在ICU的应用

目的 探讨ICU患者锁骨下静脉穿刺置管术（SVC）的操作及并发症发生情况.方法 回顾性分析2007年1 月至2011年12月接受SVC的257例ICU患者的临床资料.结果 穿刺成功率为98.1％,其中一次穿刺成功211例,重复穿刺成功41例,因患者血管变异或操作技术原因导致失败5例.并发症发生率12.1％,总计31例,其中导管尖端入颈内静脉12例,导管相关感染8例,皮下血肿6例,气胸3例,心律失常2例.结论 SVC成功率高,操作步骤易于掌握,对患者颈部及四肢活动影响小,导管保留时间较长,方便护理,感染概率低于颈内、股静脉置管.

Application of Subclavian Vein Catheterization in Intensive Care Unit

Objective To analyze the application and complications of subclavian vein catheterization （SVC） in ICU patients. Methods Clinical data of 257 patients who received SVC between January 2007 and December 2011 in ICU were analyzed retrospectively. Results Among the 257 patients, subclavian venipuncture was successful on the first attempt in 211, repeat venipuncture was performed in 41, and venipuncture was unsuccessful in 5. The total success rate was 98.1%. Thirty patients （12.1%） had complications. Among them, entrance of catheter tip into jugular vein occurred in 12, catheter-related infection in 8, subcutaneous haematomas in 6, pneumothorax in 3, and arrhythmia in 2. Conclusion SVC is easy to master with high achievement ratio and is convenient for nursing care due to the long catheter indwelling time. In addition, it has little effect on the activities of neck and limbs and causes lower infection rate than internal carotid andfemoral vein catheterization.