长期昏迷病人的颈外静脉置管输液

本文介绍我院神经外科自１９８２年以来对长期昏迷的１３３例病人以颈外静脉穿刺，置管于锁骨下静脉为主的静脉输液方法。颅内某些疾病可造成病人长期昏迷。这些病人，其中某些病例由于胃肠功能紊乱、上消化道出血以及其它一些原因不能鼻饲、周围静脉输液又有一定困难，病人的液体、电解质及营养的补充就成为神经外科医护人员十分关注的问题。颈外静脉插管可以进行输血、输液，并可按照病人的需要给予静脉高营养治疗，保证病人的营养需求。由于昏迷病人排痰反射消失，容易引起肺内感染。发生肺内感染者又多需气管切开，本文对需做气管切开同时又需做颈外插管的病例进行分析，认为只要保证插管处的无菌操作，气管切开和颈外静脉插管均可长期保留。本文还对本组颈外静脉插管出现的一些情况进行了分析。

Infusion by indwelling catheter to external carotid vein in long-term coma patients

This paper introduced the method of venous infusion through indwelling catheter mainly in subclavian vein by puncture of external carotid vein in 133 long-term coma patients of neurosurgical department from 1982 on.The long-term coma patients caused py intracranial lesions may complicate gastro-intestinal tract disturbances or hemorrhage or other conditions.These patients often cannot receive nasal feeding or peripheral venous infusion.The fluid and electrolyte balance and nutritional supplement become troublesome problem which is difficult to be managed by neurosur gical doctors and nurses.Through inswelling catheter in subclavian vein,blood transfusion and fluid infusion can proceed on and nutritional materials can be supplied according to the need of the patients to gua rante their requirement.Coma patients liable to sufferpulmonary infection due to lack of cough reflexes.In this case,tracheotomy is often manda tory.In our practice,indwelling catheter in external-carotid vein could be preserved over a long period in case of tracheotomy,provided aseptic technique is used in tracheotomy.This paper also analyzed some problems when indwelling catheter in external carotid vein is used.