摘要
目的比较颈内静脉、改良锁骨上路锁骨下静脉和传统锁骨下静脉3种路径中心静脉穿刺术在意识障碍患者中的实用性、可靠性和安全性。方法回顾性分析我院神经内科行中心静脉穿刺术的135例意识障碍患者的临床资料,其中经颈内静脉40例(J组)、改良锁骨上路锁骨下静脉58例(GS组)、传统锁骨下静脉37例(S组)。比较3组患者穿刺一次成功率、总成功率、穿刺置管时间和各种并发症。结果 J组、GS组和S组的穿刺一次成功率分别为77.5%、89.7%和59.5%,GS组高于J组和S组(P<0.05);总成功率分别为87.5%、94.8%和70.3%,GS组和J组差异无统计学意义(P>0.05),但均比S组高(P<0.05);GS组穿刺置管时间短于J组和S组(P<0.05);GS组累计并发症发生率(5.2%)低于J组(20%)和S组(29.7%),差异具有统计学意义(P<0.05)。结论相比颈内静脉和锁骨下径路,改良锁骨上路行锁骨下静脉穿刺法对于意识障碍患者来说适用体位更多,成功率更高,并发症更少。
Objective To compare the practicability,reliability and safety of three paths of central venous puncture,namely internal jugular vein,modified supra-clavicular subclavian vein and subclavian vein,for patients with consciousness disorder.Methods The clinical data of 135 patients with consciousness disorder in department of neurology were retrospectively analyzed.These patients were comprised of 40 cases of internal jugular vein puncture(group J),58 cases of modified supra-clavicular subclavian vein puncture(group GS)and 37 cases of subclavian vein puncture(group S).The one-time success rate,total success rate,puncture and catheterization time and complications were compared among the three groups.Results The one-time success rate of group GS(89.7%)was higher than that of group J(77.5%)and group S(59.5%)with significant difference(P<0.05).There was no significant difference in the total success rate between group GS(94.8%)and group J(87.5%)(P>0.05),but they were higher than that of group S(70.3%)with significant difference(P<0.05).The puncture and catheterization time in group GS was shorter than that of group J and group S with significant difference(P<0.05).The total incidence of complications of group GS(5.2%)was lower than that of group J(20%)and group S(29.7%)with significant difference(P<0.05).Conclusion Compared to internal jugular vein and subclavian vein,the modified supra-clavicular subclavian vein puncture path can adapt to more body positions,improve success rate and reduce complications in patients with consciousness disorder.
作者
刘涛
张建峰
李明强
杨婕
LIU Tao;ZHANG Jian-feng;LI Ming-qiang;YANG Jie(Department of Anesthesiology,Xiangyang Central Hospital,Affiliated Hospital of Hubei University of Arts and Science,Xiangyang Hubei 441021,China;Department of Neurology,Xiangyang Central Hospital,Affiliated Hospital of Hubei University of Arts and Science,Xiangyang Hubei 441021,China)
出处
《局解手术学杂志》
2018年第4期266-269,共4页
Journal of Regional Anatomy and Operative Surgery
基金
湖北省自然科学基金面上项目(2014CFB251)
关键词
中心静脉穿刺术
颈内静脉
锁骨上路
锁骨下静脉
central venous puncture
internal jugular vein
supra-clavicular vein
subclavian vein
