超声成像测定婴幼儿先天性心脏病患者颈内静脉横截面积及实时引导中心静脉置管术的临床意义

摘要

目的：：探讨超声实时引导行婴幼儿右侧颈内静脉穿刺置管术的临床价值。方法：选择先天性心脏病患儿拟行右侧颈内静脉穿刺置管术76例,随机分为单纯解剖标志定位组( A组)和超声实时引导定位组( B组),各38例。记录一次穿刺成功率、总穿刺成功率、平均穿刺次数、失败率和相关并发症。结果：B组一次穿刺成功率显著高于A组(P0.05), A组平均穿刺次数明显多于B组(P0.05)。结论：超声实时引导行右侧颈内静脉穿刺置管术应用于先天性心脏病婴幼儿患者,可明显提高一次穿刺成功率,减少穿刺次数,降低误穿颈动脉发生率,具有较高的临床实际应用价值。%Objective:To evaluate the clinical value of real-time ultrasound-guiding right internal jugular vein catheter in infants with congenital heart disease. Methods:Seventy-six infants with congenital heart disease scheduled by right internal jugular vein catheter were randomly divided into the anatomic mark localization group( group A) and real-time ultrasound-guiding localization group( group B)(38 cases each group). The one-time puncture success rate,total puncture success rate,average number of puncture,puncture failure rate and complications in two groups were recorded. Results:The one-time puncture success rate in group B was significantly higher than that in group A(P0. 05). The number of puncture and incidence of mistaken puncturing into carotid artery in group A were significantly higher than those in group A(P0. 05). Conclusions:The real-time ultrasound-guiding right internal jugular vein catheter in infants with congenital heart disease can significantly improve the one-time puncture success rate,decrease the number of puncture and incidence of mistaken puncturing into carotid artery,which has the high practical value in clinic.