改进颈静脉穿刺技术在下肢深静脉血栓介入治疗中的应用

摘要

Objective To evaluate the internal jugular vein puncture technique for interventional treatment of lower extremity deep venous thrombosis.Methods From February 2009 to November 2012,56 patients with lower extremity deep venous thrombosis required transjugular interventional therapy.Two methods of internal jugular vein puncture using a guide wire marking and fine needle puncture techniques was 100%without complication perforating artery.Results In 18 patients,the fine needle puncture was successful in the first attempt(12),after multiple punctures(3),unsuccessful despite repeated punctures(3)with erroneous carotid artery punctures in 2 patients.No pneumothorax,hemothorax,or cervical hematoma occurred with either technique.Conclusions Both transjugular vein puncture techniques are simple and safe with high success and low complication rates for treatment of lower extremity deep venous thrombosis.%目的：探讨改进的颈静脉穿刺技术在下肢深静脉血栓介入治疗中的应用价值。方法2009年2月～2012年11月期间，在下肢深静脉血栓介入治疗中对56例需要经颈静脉入路者，对颈内静脉穿刺进行了导丝标记法和细针穿刺法两种技术改进，观察穿刺技术改进后颈内静脉穿刺的成功率及并发症发生情况。结果38例采用导丝标记法，均一次穿刺成功，其一次穿刺成功率为100%，无1例误穿动脉；18例采用细针穿刺法，其中12例一次穿刺成功，3例多次穿刺成功，3例反复穿刺失败，2例误穿颈动脉。两种穿刺技术均未发生颈部血肿、气胸、血胸等与颈静脉穿刺相关的并发症。结论上述两种改进颈静脉穿刺技术，操作简单，成功率和安全性高，创伤小，在下肢深静脉血栓介入治疗中具有一定的应用价值。