目的：评价超声引导下，加压面罩控制通气时对急性失血性休克患者行右颈内静脉置管操作的影响。方法：40例急性失血性休克患者于气管插管全麻下行手术治疗，A组于加压面罩吸氧，自主通气下行右颈内静脉穿刺；B组于面罩通气保持15 cm H2O气道正压状态行右侧颈内静脉穿刺。记录两组环状软骨水平右颈内静脉横截面积值（S）、右颈内静脉距离皮肤最短垂直深度（D）。结果：B组加压前后S明显增加、D明显减小（P＜0.05）；B组穿刺到置管成功的时间明显减少、一次穿刺成功率明显提高(P＜0.05)。结论：清醒状态加压面罩控制通气下，较加压15 cm H2O气道压力后行右颈内静脉穿刺置管术快捷、安全，但操作期间需与患者保持沟通，并控制气道正压时间。%Objective To evaluate the ultrasound guided compression pressure control ventilation, pressure control ventilation mask on patients with acute hemorrhagic shock undergoing right internal jugular vein intuba-tion. Methods Forty cases requiring emergency surgery in acute hemorrhagic patients were intubated in the awake state before surgery; according to the different positive mask airway pressure,were randomly divided into 2 groups(n=20 each): group A (0 cm H2O), group B(15 cm H2O). The size (S) of right internal jugular veins(IJV) at the level of the cricoid and the minimum vertical depth (D) from skin to the right internal jugular vein were measured with color Doppler ultrasound in all patients. Catheterization time, the number of puncture, the num-ber of resistance, and the number of complication were recorded. Results Compared with group A, the trans-verse venous section size (S) significantly increased, while the shortest vertical depth of IJV from the skin (D) re-duced in group B. Compared with group A, the once-success rate of catheterization and the completing catheter-ization rate in 30 seconds were significantly increased (P<0.05), the number of resistance was with no signifi-cant differences in all patients(P>0.05). Conclusion The 15 cm H2O mask positive airway pressure can im-prove the once-success rate of catheterization, the completing catheterization rate in 30 seconds and decrease the occurring rate of complication for color Doppler ultrasound-guided right internal jugular vein catheterization in patients with acute hemorrhagic shock in the awake state before surgery .
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