中国胸心血管外科临床杂志

中国胸心血管外科临床杂志

婴幼儿超声预定位与解剖定位颈内静脉穿刺的对比研究

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目的 比较二维超声预定位与常规解剖定位中心静脉穿刺置管在婴幼儿中的应用。 方法  6 2例 10 kg以下先天性心脏病择期行手术治疗的患者 ,以随机数字表法分为两组 ,解剖定位组 :30例 ,以颈内动脉搏动或胸锁乳突肌三角为标志穿刺 ;超声定位组 :32例 ,使用 HP SONOS4 5 0 0型食管超声心动图 (TEE)机的术中探头 ,以二维超声图象定位中心静脉。记录穿刺针数、穿刺成功率和并发症发生率。 结果 超声定位组和解剖定位组穿刺成功率分别为 10 0 %和 80 % ,误伤动脉发生率分别为 3.1%和 2 6 .7% ,穿刺针数分别为 1.5 7± 1.0 4和 2 .5 5± 1.76 ,两组比较差别均有统计学意义 (Plt;0 .0 5 ,0 .0 5 ,0 .0 1)。 结论 婴幼儿二维超声预定位中心静脉方法简便 ,可明显提高穿刺成功率 ,降低并发症发生率。

ObjectiveTo evaluate the ultrasonic pre locating internal jugular venous cannulation in infants, comparison with the external landmark technique.MethodsSixty two infants scheduled for cardiac surgery were randomized prospectively into two groups. In the anatomic landmarks group( n =30), the patient’s internal jugular vein(IJV) were cannulated by using the traditional method of palpation of carotid pulsation and identification of other anatomic landmarks. In the ultrasonic pre locating group ( n =32), an two dimensional ultrasound scanner image made for locating the puncture site of vessels was used with an operative probe of HP SONOS 4500 system. The number of attempts, success rate, and incidence of complications were compared for two groups.ResultsThe success rate was 100% vs 80% in the ultrasonic pre locating group vs anatomic landmarks group, with a 3.1% vs 26 7% incidence of carotid artery punctures and the number of attempts 1.57±1.04 vs 2.55±1.76. All differences were statistically significant ( P lt;0.05,0.05,0.01). Conclusion Ultrasonographic pre-localization of the IJV is superior to the anatomic landmarks technique in terms of overall success , and decreases incidence of carotid artery puncture.

关键词: 婴幼儿; 二维超声心动图; 颈内静脉

Key words: Infant; Two-dimensional ultrasonography; Internal jugular vein

引用本文: 魏新川,魏蔚,李羽. 婴幼儿超声预定位与解剖定位颈内静脉穿刺的对比研究. 中国胸心血管外科临床杂志, 2005, 12(1): 15-18. doi: 复制

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