实时超声引导在危重症患者床旁颈内静脉置管术中的应用

摘要

Objective :To obseive the efficacy of real‐time ultrasound‐guided bedside internal jugular vein catheteriza‐tion in critically ill patients .Methods :63 cases of critically ill patients were randomized into tow groups :real‐time guided internal jugular cannulation cases in group U (n=33) and anatomic landmark guided cases in group A (n=30) . Compared the success rate and the first puncture success rate of catheterization ,the number of attempts for successful catheterization ,the time spent for successful and arising complications .between group U and group A .Results:There were no significant differences in the demographic features between the two groups (P> 0 .05) .The success rate and the first puncture success rate of catheterization were significant higher in group U than in group A (P<0 .05) .The number of attempts for successful catheterization was satistically lower in group U than in group A (P<0 .01) .And ar‐terial punction complication was increased significantly in group A (P<0 .05) .Conclusion:Bedside internal jugular vein catheterization guided by real‐time ultrasound was superior to by anatomic landmark in critically ill patients .%目的：探讨实时超声引导用于危重症患者床旁颈内静脉置管术可行性。方法：手术室外需要颈内静脉置管的危重症患者63例，随机分入实时超声引导组（U组，n＝33）、体表解剖标志定位组（A组，n＝30）。比较两种方法引导颈内静脉穿刺的总成功率、一次成功率、穿刺次数、穿刺时间及并发症。结果：超声引导组总成功率和一次成功率均高于体表解剖定位组（P＜0．05），穿刺次数和穿刺时间均少于体表解剖定位组（P＜0．01），误穿动脉发生率低于体表解剖定位组（P＜0．05）。结论：实时超声引导重症患者床旁颈内静脉置管优于体表解剖定位法，安全可行。