超声下两种颈内静脉置管法的比较

目的：超声下比较两种路径颈内静脉置管方法的准确性及并发症的发生率,寻找更安全、可靠的颈内静脉穿刺路径。方法选择需行颈内静脉穿刺患者60例,随机分为传统中路法穿刺组(A组,n=30)与颈内静脉搏动点法穿刺组(B组,n=30)。观察颈总动脉直径(D1)、颈内静脉直径(D2)、颈总动脉和颈内静脉重叠覆盖率、穿刺路径距颈内静脉中心距离(D3)、穿刺路径距颈总动脉外侧距离(D4)及可能触及颈总动脉例数。结果与A组比较,B组D3较小,差异有统计学意义(P<0．05)；B组D4明显大于A组,差异有统计学意义(P<0．05)。结论颈内静脉搏动点法行颈内静脉穿刺更准确,并发症发生率更低。

Comparison of two kinds of internal jugular vein catheter method by ultrasound

Objective To find out a more secure and reliable internal jugular vein puncture channel by comparing the accuracy, complication incidence of two kinds of channel of internal jugular vein catheterization by ultrasound. Methods Totally 60 patients were ran-domly assigned to receive the internal jugular vein catheterization using either traditional central approach (group A, n=30) or internal jugu-lar vein pulsing (group B, n=30). The diameter of the carotid artery (D1) and the internal jugular vein(D2), the overlapping coverage of carotid artery and internal jugular vein, the distance from the center of internal jugular vein to puncture path(D3) and from the lateral of the common carotid artery to puncture path (D4), the number of cases that may reach the common carotid artery were recorded. Results The distance from the center of internal jugular vein to puncture path(D3) in group B was shorter than that in group A(P<0. 05);in addition, the distance from the lateral of the common carotid artery to puncture path(D4) was significantly longer compared with that in group A(P<0. 05). Conclusion Puncture in the place internal jugular vein pulsing can increase the success rate of right internal jugular vein catheter-ization and reduce puncture-related complications.