摘要【目的】探讨超声可视化在婴儿颈内静脉穿刺置管术中的应用价值。【方法】选择60例1岁以下须颈内静脉穿刺置管的患儿,随机分为超声引导组(A组)和解剖定位组(B组),每组30例。A组采用超声可视化穿刺置管,B组采用解剖标志定位穿刺置管,比较两组患儿首次穿刺成功率、总成功率、总穿刺时间、穿刺次数及并发症发生情况。【结果】A组首次成功率、总成功率均高于B组,而穿刺次数和总穿刺时间均少于 B 组,差异均有显著性( P <0.05 );与B 组相比,A组出现血肿、损伤动脉等并发症较少,其差异均有统计学意义( P<0.05 )。两组患儿均未出现血气胸等严重并发症。【结论】围术期婴儿行颈内静脉穿刺置管时,应用超声可视化技术可有效提高穿刺成功率,减少穿刺时间,降低穿刺相关并发症,值得临床推广应用。
[1] Shime N.Ultrasound imaging reduces failure rates of percutaneous central venous catheterization in children[J].Pediatr Crit Care Med, 2015, 16(8): 718-725. [2] Hoffman T, Du Plessis M, Prekupec MP,et al.Ultrasound-guided central venous catheterization: A review of the relevant anatomy, technique, complications, and anatomical variations[J].Clin Anat,2017,30(2):237-250. [3] Lau CS, Chamberlain RS. Ultrasound-guided central venous catheter placement increases success rates in pediatric patients: a meta-analysis[J].Pediatr Res,2016,80(2):178-184. [4] 杜真,张溪英,屈双权.超声技术在小儿麻醉中的应用进展[J].临床小儿外科杂志,2015,14(5):428-432.[5] Ghatak T, Singh RK, Baronia AK. Comparison between marked versus unmarked introducer needle in real-time ultrasound-guided central vein cannulation: A prospective randomized study[J].Ann Card Anaesth,2016,19(4):621-625. [6] 王俊林,仲山,黄洪强,等.超声引导下颈内静脉置管在新生儿手术中的应用[J].临床麻醉学,2017,33(10):1027-1028. [7] 马岩.不同左偏头位下右侧颈内静脉与颈总动脉的关系分析[J].国际麻醉学与复苏杂志,2017,38(5):414-417. [8] Chen GY, Cheng KI, Hsu HT,et al.Ultrasound-guided central venous catheterization in the prone position[J].Br J Anaesth,2017,119(2):337-338. [9] 杨柯.超声定位在产科手术术中颈内静脉穿刺置管中的应用[J].医学临床研究, 2017,34(3):615-616.
2019, Vol. 36 
