颈内静脉置管的临床特征分析

目的了解颈内静脉置管的方法和优点。方法选择右侧颈内静脉穿刺,体表位置容易掌握。16例尿毒症患者采用经皮隧道植入长期中心静脉导管。结果695例患者穿刺置管710例次,其中645例患者穿刺成功,成功率90.8%,37例患者透析4~49d后出现感染,占透析患者总数6.4%,31例穿刺针误入右颈总动脉,占患者总数4.5%,须拔针,充分压迫止血。结论颈内静脉置管操作简单,安全,成功率高,血管损伤小,留置时间长,尤其适用于慢性肾衰竭新建动静脉内瘘成熟前的初期血液透析阶段,也适用于危重患者建立静脉输液通道。尿毒症患者动静脉内瘘建立困难时可以采用长期中心静脉导管解决血管通路。

Clinical analysis of jugular vein catheter

Objective To evaluate the clinical application of jugular vein catheter in patients.Methods Right internal jugular vein were selected for puncture in all patients.It′s easy to control the body surface position.The long-term central venous catheter were inserted through subcutaneous tunnel in 16HD patients.Results In 695 cases（710 times）punctured,645 cases were successfully punctured and the successful rate was 90.8%,37 cases got infection after 4~49days,the rate of which were 6.4%.31 cases were punctured into the right common carotid artery,the rate of which was 4.5%that should pull out the needle and press the pinprick sufficiently.Conclusion The performing of jugular vein catheter is simple.Safe with high successful rate and little injury to the vein as well as relative long use makes it not only applicable to the patients in their initial stage of HD before A-V fistula could be used,but also to the patients who were in dire need of vein access for remedy.If it′s difficult to build the A-V fistula in some patients,it could use the long-term central venous catheter to replace it.