彩色超声与盲探穿刺右颈内静脉并发症比较

目的比较彩色超声引导与盲探穿刺右侧颈内静脉置管术的并发症情况。方法将我院拟择期(在腹腔镜下)行结直肠肿瘤切除术的患者100例,ASA分级Ⅰ~Ⅲ级,年龄23~81岁,体重32~81kg。采用抛硬币法将患者随机分为彩色超声组(C)和盲探穿刺组(M)各50例。记录两组病人黑色细针试穿中静脉时次数、薄壁蓝空针穿刺中静脉时次数、穿刺点的数目、导管置入失败的次数,并记录病人由于穿刺引起的机械并发症及术后留置导管并发症情况。结果两组患者均未见明显机械并发症,且两组比较无统计学意义;两组无误穿动脉、血气胸及心律失常或心脏损伤的情况。结论彩色超声引导下行右颈内静脉穿刺成功率较盲探穿刺高,盲探穿刺刺破颈内静脉后壁概率较彩色多普勒超声引导下穿刺组高,其余机械并发症及留置中心静脉导管并发症比较无统计学意义。

Compare the complications of the color with blind agent puncture by ultrasound right internal jugular vein complications

Objective Compare the complications of the color with blind agent puncture guided by ultrasound right internal jugular vein catheter complications . Methods Quasi haing electie colorectal tumor resection of 100 cases of patients ,ASA class Ⅰ ~ Ⅲ ,aged 23~81 ,32~81 kg weight（On laparoscopic） .Patients were randomly in two groups （n=50）：color ultrasound group （C） and blind puncture group （M ） by using flip a coin .Records in the two groups of patients with needle try ein number ,thin blue empty needle puncture veins in number ,the number of the puncture point ,the number of failed catheterization and record patients caused by puncture mechanical compli‐cations and postoperative complications of indwelling catheter . Results Group C and group M not seen signifi‐cant mechanical complications ,and comparing the two groups has no statistical significance .Two groups are not ap‐parent subcutaneous hematoma puncture ,and correct in arteries ,hemopneumothorax and arrhythmia or heart dam‐age . Conclusion Color ultrasound guided right internal jugular vein puncture success rate is higher than blind a‐gent puncture ,blind agent after puncture pricking internal jugular vein wall probability is greater than color doppler ultrasound ,the rest of the mechanical complications and complications indwelling central venous catheter is no sta‐tistical significance .