CAJ | 학술논문

目的：皮下潜行法颈内静脉穿刺置管与中路颈内静脉穿刺置管进行比较，评价其可行性。方法选择脊柱手术病人80例，随机分为2组，每组40例，A组皮下潜行法颈内静脉穿刺置管，B组中路颈内静脉穿刺置管。观察记录总穿刺成功率、一次试穿成功率、置管成功率及并发症，并均于术后摄胸部平片观察中心静脉导管的位置，记录导管留置时间及导管相关性感染发生率。结果 A组穿刺总成功率97.50%，一次试穿成功率90.00%，无误穿动脉、气胸、血胸及导管异位等并发症发生，与B组比较无显著差异（P>0.05）。 A组导管平均留置时间（15.2±2.3）d，无导管相关性感染，B组导管平均留置时间（9.5±1.5）d，导管相关性感染4例（10.00%）。 A组导管相关感染率明显低于（P=0.04），而导管留置时间明显高于B组（P=0.00）存在明显区别。结论皮下潜行法颈内静脉穿刺置管具有操作容易、安全性大、导管留置时间长、导管相关性感染率低等特点，具有实用价值。
목적：피하잠행법경내정맥천자치관여중로경내정맥천자치관진행비교，평개기가행성。방법선택척주수술병인80례，수궤분위2조，매조40례，A조피하잠행법경내정맥천자치관，B조중로경내정맥천자치관。관찰기록총천자성공솔、일차시천성공솔、치관성공솔급병발증，병균우술후섭흉부평편관찰중심정맥도관적위치，기록도관류치시간급도관상관성감염발생솔。결과 A조천자총성공솔97.50%，일차시천성공솔90.00%，무오천동맥、기흉、혈흉급도관이위등병발증발생，여B조비교무현저차이（P>0.05）。 A조도관평균류치시간（15.2±2.3）d，무도관상관성감염，B조도관평균류치시간（9.5±1.5）d，도관상관성감염4례（10.00%）。 A조도관상관감염솔명현저우（P=0.04），이도관류치시간명현고우B조（P=0.00）존재명현구별。결론피하잠행법경내정맥천자치관구유조작용역、안전성대、도관류치시간장、도관상관성감염솔저등특점，구유실용개치。
Objective To subcutaneous sneak method of internal jugular vein catheterization and middle internal jugular vein puncture compared catheterization, to evaluate its feasibility. Methods 80 cases of spinal operation patients, randomly divided into 2 groups, 40 cases in each group, A group was prowling the method of internal jugular vein catheterization, B group the middle internal jugular vein catheterization. Observe and record the success rate, a try on the success rate, success rate and complications of catheterization total puncture, and all the plain chest film of central venous catheter position after operation to record, indwelling catheter time and incidence of catheter related infections. Results In A group, puncture success rate of 97.50%, a try on the success rate of 90%, no errors, pneumothorax, hemothorax and perforating artery catheter heterotopia and other complications, no significant difference compared with B group (P>0.05). A group of average retention time 15.2 ±2.3 days, no catheter-related infection, catheter indwelling time of group B, average 9.5 ±1.5 days, 4 cases of catheter-related infection (10%). Catheter related infection rate in A group was significantly lower than that (P=0.04), and the catheter indwelling time were higher than those in B group (P=0.00) has the obvious difference. Conclusion Subcutaneous stealth method of internal jugular vein catheterization with easy operation, high safety, long time of indwelling catheter, catheter related infection rate is low, it has practical value.