280例锁骨下静脉穿刺置管分析

目的探讨危重患者锁骨下静脉穿刺置管的方法及并发症防治,提高锁骨下静脉穿刺置管术的成功率。方法回顾我院重症医学科280例经锁骨下静脉穿刺置管患者的临床资料。结果一次穿刺成功213例（76.1%）,二次成功42例（15.0%）,总穿刺成功率（91.1%）,留管3～48d,平均（13.8±7.6）d;失败10例（3.6%）。穿刺置管引起并发症15例（5.4%）,其中误入颈内静脉6例,气胸4例,误穿锁骨下动脉3例,穿刺点血肿2例。结论锁骨下静脉穿刺置管成功率高、并发症少、留管时间长、便于护理,但必须熟悉解剖结构、严格无菌操作并掌握并发症的原因及处理。锁骨下静脉穿刺置管术是危重症患者较为安全的静脉穿刺方法。

Clinical observation of Subclavian venepuncture and catheterization(Report of 280 cases)

Objective To explore the method and how to prevent and treat the complications of subclavian vein catheterization in ICU and seek for ways to improve the efficiency of subclavian venepuncture and catheterization. Methods 280 patients who underwent subclavian venepunture and catheterization in ICU of hospital were retrospectively evaluated. Results Among these 280 patients, 213 cases got puncturecl only one time, the ratio was 76.1%. 42 cases got socond time, and the ratio was 15.0%. General success punctura...