Schummer W, Schummer C, Voigt R, Heyne J, Steenbeck J
Klinik fär Anästhesie und Intensivtherapie, Friedrich-Schiller-Universität, Jena.
Anasthesiol Intensivmed Notfallmed Schmerzther. 2003 Aug;38(8):542-6. doi: 10.1055/s-2003-41191.
Internal jugular vein catheterization is nowadays a routine procedure in clinical practice. Arterial puncture is the most common complication of internal jugular vein catheterization. Two cases of pseudoaneurysm formation as a complication of accidental arterial puncture in liver transplant patients with coagulopathy are presented. Punctures of the common carotid artery, thyrocervical trunk, respectively were the source for these lesions. Coagulopathy is seen as an essential factor in the formation of pseudoaneurysm. Especially in patients with coagulopathy the threshold for ultrasound guidance should be low. Under these circumstances using the external jugular vein seems to be more prudent as it eliminates the risk for arterial punctures. We illuminate the genesis, signs and symptoms, diagnosis, and therapy of pseudoaneurysm. Recommendations for risk reduction are given.
如今，颈内静脉置管在临床实践中是一项常规操作。动脉穿刺是颈内静脉置管最常见的并发症。本文介绍了两例肝移植合并凝血功能障碍患者因意外动脉穿刺并发症形成假性动脉瘤的病例。颈总动脉、甲状腺颈干穿刺分别是这些病变的来源。凝血功能障碍被视为假性动脉瘤形成的关键因素。特别是对于凝血功能障碍患者，超声引导的阈值应较低。在这种情况下，使用颈外静脉似乎更为谨慎，因为它消除了动脉穿刺的风险。我们阐述了假性动脉瘤的发生、体征和症状、诊断及治疗方法。并给出了降低风险的建议。
