颈内静脉的影象学分析

目的：确定颈内静脉穿刺的最佳部位方法随机抽取３１例成年人的颈部核磁共振图象和２０例青年志愿者颈部超声图像，取甲状软骨上缘、环状软骨、第７颈椎３个横截面的图象，分别观察和测定动静脉前后关系、动静脉内外关系、静脉到皮肌的距离。２０例青年志愿者中，１０例探头置于环状软骨平面的气管两侧，在枕肩仰卧、去枕仰卧位、头低足高３种体位下，测定静脉的直径与呼吸的关系。结果：颈总动脉与颈内静脉紧密相连；颈内静脉有从上到下依次在动脉的后面过渡到平行、前面的趋势（Ｐ＜０．０１）；三个平面自上而下颈内静脉前壁与颈前皮肤的距离依次变短（Ｐ＜０．０１）；颈内静脉的直径在相同的呼吸状态，肩枕仰卧位＜去枕头正仰卧位＜头低足高位（Ｐ＜０．０１），在所观察的体位颈内静脉的直径都是深吸气＜平静呼吸＜深呼气（Ｐ＜０．０１）。结论　环状软骨平面颈总动脉外侧０．５ｃｍ处为颈内静脉穿刺的最佳进针点。

Imageology Investigation of Internal Jugular Vein

Object :To define the optimal site . Metholds: The cervical nuclear magnetic images of 31 adults and the ultrasound images of 20 youth volunteers were randomly selected.The adjacent relatioship between the common carotid artery and the internal jugular vein at three cross sections (the upper border of the thyroid cartilage,the cricoid cartilage and the seventh cervical vertebra transverse section)was analyzed on those images.The distance from the internal jugular vein to skin was determined also.Results:The internal jugular vein(IJV)and the common carotid artery (CCA)connect tightly to each other.From the top to down, the IJV is behind the CCA,then parallels to the later,at the last cross section it is in front of CCA.From the upper border of the thyroid cartilage to the seventh cervical vertebra area,the distance between the IJV and skin becomes shoter.Conclusions:The optimal site of internal jugular vein puncture is 0.5cm from the common carotid artery at the cricoid cartilage transverse section.