超声引导下行颈内静脉穿刺置管术在尿毒症患者中的临床应用

目的探讨超声引导下右颈内静脉穿刺置管术在尿毒症患者中的应用价值。方法需进行血液透析的尿毒症患者共60例，随机分为超声引导定位组和对照组各30例，超声引导组进行选择性定位，实时超声引导下穿刺置管，对照组采用传统体表标志定位穿刺置管，记录并对比观察二组的置管时间、一次成功率及并发症发生率，对结果进行对比分析。结果超声引导组30例患者均穿刺置管成功（100％），一次穿刺成功28例（93．3％）、出现并发症2例（6．6％），对照组30例患者穿刺置管成功22例（73%），一次穿刺成功16例（53．3％），出现并发症11例（36．6％），且置管时间对照组明显高于超声引导组（P〈0．05）。结论行超声引导下颈内静脉穿刺置管术明显提高穿刺置管的成功率及安全性，降低并发症的发生率，具有重要的临床应用价值。

CLINICAL SIGNIFCANCE OF ULTRASOUND GUIDED INTERNAL JUGULAR VEIN CATHETER-IZATION IN PATIENTS WITH UREMIA

Objective To explore the value of ultrasound- guided right internal jugular vein catheter-ization in patients with uremia. Methods Totally 60 uremic patients needed hemodialysis were ran-domly divided into two groups, 30 cases in each group. Ultrasound- guided group performed selective localization and real - time ultrasound - guided percutaneous catheter. Control group received conven-tional locative catheterization. The catheterization time, a success rate and complication rate were re-corded and compared between the two groups. Results All 30 patients of ultrasound-guided group were successfully cannulated（100%）, a successful puncture in 28 cases（93.3%）, complications in 2 cases （6.6%）. 22 patients in control group were cannulation success （73%）, a successful puncture in 16 cases （53.3%）, 11 cases with complications （36. 6%）. Catheterization time was significantly high-er in control group than ultrasound-guided group （p 〈0.05）. Conclusion Ultrasound-guided inte-rnal jugular vein catheterization significantly improves the success rate of catheterization and safety, reduces the incidence of complications. It shows an important clinical value.