Dolla D, Cavatorta F, Galli S, Zollo A, Ervo S
Radiology Service, General Hospital, Imperia - Italy.
J Vasc Access. 2001 Apr-Jun;2(2):60-3. doi: 10.1177/112972980100200207.
The internal jugular vein (IJV) should be the preferred form of venous vascular access for the placement of dialysis catheters. 'Blind' puncture or 'skin mark' ultrasound technique puncture present multiple complications due to the significant variations in IJV location in normal subjects and even more so in uremic pa-tients. The aim of this study is to demonstrate the important rate of IJV site variations in a random healthy pop-ulation. We tested 450 subjects (244 male, 206 female) in our hospital Ultrasound Ambulatory using an Ansaldo AUS ul-trasound device with linear 10 MHz probe on both sides at the Sedillot triangle level and noticed the relations between IJV and carotid artery course. The most frequent location of IJV was the anterior lateral (79.3% on the right side, 83.5% on the left). The re-maining options were lateral, anterior, posterior-lateral, anterior-medial. We found no significant difference in IJV diameter on either side of the neck. We therefore consider IJV puncture with ultrasound guidance to be the first choice in central venous cannulation for hemodialysis treatment. This procedure helps avoid incorrect puncture of the carotid artery related to its abnormal location.
颈内静脉（IJV）应是放置透析导管时静脉血管通路的首选形式。“盲目”穿刺或“皮肤标记”超声技术穿刺会出现多种并发症，这是因为正常受试者的颈内静脉位置存在显著差异，在尿毒症患者中更是如此。本研究的目的是证明在随机健康人群中颈内静脉位置变异的重要发生率。我们在我院超声门诊使用安萨尔do AUS超声设备，配备10 MHz线性探头，在Sedillot三角水平对450名受试者（244名男性，206名女性）双侧进行检测，并观察颈内静脉与颈动脉走行之间的关系。颈内静脉最常见的位置是前外侧（右侧为79.3%，左侧为83.5%）。其余位置为外侧、前侧、后外侧、前内侧。我们发现颈部两侧的颈内静脉直径无显著差异。因此，我们认为超声引导下的颈内静脉穿刺是血液透析治疗中心静脉置管的首选方法。该操作有助于避免因颈动脉位置异常而导致的误穿刺。
