改良斜轴面超声方法引导患者颈内静脉穿刺置管效果观察.doc

作者单位：王伟，浙江大学医学院附属第一医院麻醉科，310003，现工作于金华市中心医院麻醉科， 321000；温小红，浙江大学医学院附属第一医院麻醉科，310003. 通讯作者：温小红，浙江大学医学院附属第一医院麻醉科，310003，Email：wenxiaohong6965@163.com. 已增加不同截面的配图; 已修改为半角格式 已引用贵刊一篇文章 已增加探头示意图 斜轴面超声方法引导颈内静脉穿刺置管效果观察 王伟 温小红(浙江大学医学院附属第一医院,浙江 杭州 310003) 摘要 目的 评价斜轴面超声方法引导颈内静脉穿刺置管效果?方法 选择需要颈内静脉穿刺置管的手术患者120例,ASA分级Ⅰ-Ⅲ级,年龄25~78 岁,性别不限,体重47~81KG?采用随机数字表法,将其分为3组(n=40):短轴组(A组)?长轴组(B组)和斜轴组(C组)? A组以短轴面即颈内静脉横向截面图下引导颈内静脉穿刺,B组以长轴面即颈内静脉长轴截面图下引导颈内静脉穿刺,C组为在环状软骨平面按短轴法定位颈内静脉后,把超声探头顺时针旋转45-55°,获得颈内静脉及周围组织的斜轴面图下引导颈内静脉穿刺,记录3组各自穿刺次数?一次穿刺成功例数,穿刺失败例数,穿刺时间?穿刺并发症的发生情况?结果 与A?B组比较,C组穿刺时间时间减少,差异有统计学意义(P0.01),与A组比较,C组穿刺并发症发生率降低(P0.05)?结论 斜轴面超声引导穿刺颈内静脉是一个更加安全?有效的方法? 关键词:超声引导;斜轴面;颈内静脉穿刺 Effect of ultrasound guided the internal jugular vein catheterization on oblique axial plane Wang Wei,Wen Xiaohong. Department of Anesthesia, The Frist Affiliated Hospital,Zhejiang University, Hangzhou, 310003,China [Abstract] Objective To evaluate the effect of ultrasound guided the internal jugular vein catheterization on oblique axial plane. Methods One hundred and twenty ASA physical status I –III surgery patients, aged 25 ~ 78 yr, weighing47 ~ 81 kg, scheduled for internal jugular vein catheterization,were randomly divided into 3 groups (n = 40) : short axial group (group A), the long axial group (group B) and oblique axial group (group C).Group A used the ultrasound guided the internal jugular vein catheterization on the transverse plane of the internal jugular vein, which named shorter axial plane, group B used the ultrasound guided the internal jugular vein catheterization on longitudinal section of internal jugular vein,which named long axial plane, group C used the method of the short axis plane in the level of cricoid cartilage to located the internal jugular vein, then rotated the ultrasonic sensor 45-55 degrees clockwise, guided the internal jugular vein catheterization in this plane,which named oblique axial plane?Recorded the numbers of puncture,one-time puncture success cases, puncture failure cases,