中华医学超声杂志（电子版）
中華醫學超聲雜誌（電子版）
중화의학초성잡지（전자판）
CHINESE JOURNAL OF MEDICAL ULTRASOUND(ELECTRONICAL VISION)
2012年
6期
491-494
,共4页
超声检查%婴儿,新生%颈内静脉穿刺
超聲檢查%嬰兒,新生%頸內靜脈穿刺
초성검사%영인,신생%경내정맥천자
Ultrasonography%Infant,newborn%Internal jugular vein cannulation
目的观察超声引导技术在新生儿(包括低体重儿)颈内静脉穿刺置管中的应用.方法 选取62例行胸腹部手术及体表大肿瘤切除术的新生儿(包括低体重儿),随机分成超声引导组(UG组)及体表标志定位组(S组),两组均先使用22G静脉留置针,穿刺置入外套管成功后,再行钢丝引导法置入双腔中心静脉导管.观察两组穿刺操作的成功率、更换穿刺点的次数、穿刺并发症及平均穿刺时间.结果 UG组的穿刺成功率为96.8%(30/31),明显高于S组的32.3%(10/31),差异有统计学意义(χ2=28.182,P=0.000);UG组的更换穿刺点的例数(2例)亦明显低于S组的例数(25例);穿刺并发症发生率为3.2%(1/31),亦低于S组的64.5%(20/31),差异有统计学意义(χ2=25.995,P=0.000);UG组平均穿刺时间为(4.366±1.137) min,S组平均穿刺时间为(13.70±5.34)min,两组比较差异有统计学意义(t=5.463,P=0.028).结论 超声引导新生儿颈内静脉穿刺是安全可行的技术,可极大提高穿刺成功率和减少穿刺并发症的发生.
目的觀察超聲引導技術在新生兒(包括低體重兒)頸內靜脈穿刺置管中的應用.方法 選取62例行胸腹部手術及體錶大腫瘤切除術的新生兒(包括低體重兒),隨機分成超聲引導組(UG組)及體錶標誌定位組(S組),兩組均先使用22G靜脈留置針,穿刺置入外套管成功後,再行鋼絲引導法置入雙腔中心靜脈導管.觀察兩組穿刺操作的成功率、更換穿刺點的次數、穿刺併髮癥及平均穿刺時間.結果 UG組的穿刺成功率為96.8%(30/31),明顯高于S組的32.3%(10/31),差異有統計學意義(χ2=28.182,P=0.000);UG組的更換穿刺點的例數(2例)亦明顯低于S組的例數(25例);穿刺併髮癥髮生率為3.2%(1/31),亦低于S組的64.5%(20/31),差異有統計學意義(χ2=25.995,P=0.000);UG組平均穿刺時間為(4.366±1.137) min,S組平均穿刺時間為(13.70±5.34)min,兩組比較差異有統計學意義(t=5.463,P=0.028).結論 超聲引導新生兒頸內靜脈穿刺是安全可行的技術,可極大提高穿刺成功率和減少穿刺併髮癥的髮生.
목적관찰초성인도기술재신생인(포괄저체중인)경내정맥천자치관중적응용.방법 선취62례행흉복부수술급체표대종류절제술적신생인(포괄저체중인),수궤분성초성인도조(UG조)급체표표지정위조(S조),량조균선사용22G정맥류치침,천자치입외투관성공후,재행강사인도법치입쌍강중심정맥도관.관찰량조천자조작적성공솔、경환천자점적차수、천자병발증급평균천자시간.결과 UG조적천자성공솔위96.8%(30/31),명현고우S조적32.3%(10/31),차이유통계학의의(χ2=28.182,P=0.000);UG조적경환천자점적례수(2례)역명현저우S조적례수(25례);천자병발증발생솔위3.2%(1/31),역저우S조적64.5%(20/31),차이유통계학의의(χ2=25.995,P=0.000);UG조평균천자시간위(4.366±1.137) min,S조평균천자시간위(13.70±5.34)min,량조비교차이유통계학의의(t=5.463,P=0.028).결론 초성인도신생인경내정맥천자시안전가행적기술,가겁대제고천자성공솔화감소천자병발증적발생.
Objective To investigate the application of the ultrasonic guidance-assisted neonatal internal jugular vein catheterization.Methods Sixty two newborns (including low birth weight infants) receving thoracic/abdominal operation or resection of malignant tumor on the body-surface were randomly assigned to ultrasound guidance (UG) group or surface mark landmark(S) group.Newborns in both groups were all punctured with 22G venous indwelling needles to place the external casing,followed by the steel wire guidance-assisted implantation of ARROW 4F dual chamber central venous catheter.Then we compared the rate of successful insertion attempt,rate of malpositioning,complications and average operation time between the two groups.Results The rate of successful insertion attempt was 96.8%(30/31) in the UG group,significantly higher than that in the S group (32.3%,10/31),there was significant difference between the two groups(χ2=28.182,P=0.000).Malpositioning happened in 2 cases in the UG group,but 25 cases in the S group.Rate of complications was higher in the S group compared to the UG group (64.5% vs 3.2%,χ2=25.99,P=0.000).Most importantly,the average operation time was (4.366±1.137)min in the UG group,significantly shorter than that of the S group [(13.70±5.34)min,t=5.463,P=0.028)].ConclusionUltrasound guidance-assisted catheterization for neonatal internal jugular vein is safe and feasible and can dramatically improve the success rate and prevent complications.
