超声实时引导与传统体表标志定位颈内静脉插管术的比较

目的比较超声实时引导和传统体表标志定位两种颈内静脉插管方法的成功率及穿刺并发症的发生率。方法采用双盲1：1分层随机对照临床试验，纳入2006年2月至2007年1月本院肾内科120例需建立颈内静脉通路、用于输液或血液透析的患者，随机分为超声引导组与体表定位组，每组60例。结果超声引导组颈内静脉插管全部成功，体表定位组成功53例，占88．3％，（P=0．006），两种方法首次插管成功率分别为95．0％和76．7％（P=0．004）。体表定位组共发生穿刺并发症10例，超声引导组无相关穿刺并发症发生。结论超声实时引导颈内静脉插管术安全有效。

Comparison of the real-time ultrasonographic guidance vs the traditional landmark technique for the insertion of internal jugular vein catheters

Objective To compare the real-time ultrasonographic guidance vs the traditional landmark technique for the insertion of internal jugular vein catheters, and to define the efficacy and safety of these two approaches. Methods By using a double-blinded 1 ： 1, prospective, randomized, stratified clinical study, 120 cases requiring central venous access and hemodialysis were equally randomized into two groups from February 2006 to January 2007. Results The success rate of catheterization in real-time ultrasonographic guidance group and landmark technique group was 100% and 88. 3% respectively （P = 0. 006）. The success rate of one attempt in real-time ultrasonographic guidance group and landmark technique group was 95.0% and 76. 7% respectively （P = 0. 004）. In landmark technique group, complications occurred in 10. Conclusions Ultrasound-guided catheterization of the internal jugular vein is quick, safe and effective.