CAJ | 학술논문

目的评价超声引导下颈内静脉穿刺术在强直性脊柱炎(ankylosing spondylitis,AS)患者全身麻醉诱导后深静脉通路建立过程中的应用价值. 方法选择20例拟择期行后路经椎弓根截骨矫形内固定术的AS患者,采用随机数字表法分为M组和C组,每组10例.全身麻醉诱导成功后,M组和C组分别采用体表标志定位法(盲穿法)和超声引导(可视化)行深静脉穿刺置管术,比较两种方法在一次性成功率、穿刺次数、穿刺时间、整体成功率、并发症发生率等方面的差异. 结果 M组一次性成功率低(20％),穿刺次数多(≥3处),失败率高(40％),误入动脉(30％)及局部血肿(20％)的并发症发生率高;C组一次性成功率高(70％),穿刺次数少(＜3处),100％成功,误入动脉(0)及局部血肿(10％)的并发症发生率极低;M组与C组比较,在穿刺次数、一次性成功率、整体成功率、误入动脉并发症4方面差异均存在统计学意义(P＜0.05). 结论超声引导下颈内静脉穿刺术应用于AS患者,具有一次性成功率高、穿刺次数少、耗时短、100％成功的优势,明显减少相关并发症.
목적 평개초성인도하경내정맥천자술재강직성척주염(ankylosing spondylitis,AS)환자전신마취유도후심정맥통로건립과정중적응용개치. 방법 선택20례의택기행후로경추궁근절골교형내고정술적AS환자,채용수궤수자표법분위M조화C조,매조10례.전신마취유도성공후,M조화C조분별채용체표표지정위법(맹천법)화초성인도(가시화)행심정맥천자치관술,비교량충방법재일차성성공솔、천자차수、천자시간、정체성공솔、병발증발생솔등방면적차이. 결과 M조일차성성공솔저(20％),천자차수다(≥3처),실패솔고(40％),오입동맥(30％)급국부혈종(20％)적병발증발생솔고;C조일차성성공솔고(70％),천자차수소(＜3처),100％성공,오입동맥(0)급국부혈종(10％)적병발증발생솔겁저;M조여C조비교,재천자차수、일차성성공솔、정체성공솔、오입동맥병발증4방면차이균존재통계학의의(P＜0.05). 결론 초성인도하경내정맥천자술응용우AS환자,구유일차성성공솔고、천자차수소、모시단、100％성공적우세,명현감소상관병발증.
Objective To evaluate the application of ultrasound guided internal jugular vein catheterization in the process of deep vein puncture in patients with ankylosing spondylitis(AS) after anesthesia induction.Methods Twenty AS patients scheduled for an elective pedicle subtraction osteotomy were enrolled in this study.The subjects were randomly assigned to receive the right internal jugular vein catheterization using either ultrasound-guided technique (group C,n=10) or traditional surface marker localization (group M,n=10).One-time pun-cture success rate,number of punctures,duration of the procedure,total success rate and incidence of complication rate were compared between these two groups.Results The result of group M was extremely low,success rate at one-time puncture was(20％),several punctures(≥ 3),high failure rate(40％),high rate of arterial damage related complication(30％) and local hematoma(20％).Group C had higher success rate(70％) at one-time puncture,fewer repetitive punctures (＜3),100％ success rate,lower complication rate due to artery damage(0％) and local hematoma(10％).Compared with group M,there were statistical differences at the four aspects of one-time success rate,number of repeated punctures,total success and complication of artery damage (P＜0.05).Conclusions The application of ultrasound guided internal jugular vein catheterization in patients with AS has superior results,higher one-time success rate,fewer times of punctures,shorter time required for the procedure and 100％ success rate.