Scheiermann P, Seeger F H, Breitkreutz R
Klinik für Anaesthesiologie, Klinikum der Ludwig-Maximilians-Universität München, Deutschland.
Anaesthesist. 2010 Jan;59(1):53-61. doi: 10.1007/s00101-009-1644-7.
Central venous line placement is a standard procedure in critical care and peri-operative medicine. This procedure can be associated with severe complications. In contrast to the landmark technique, ultrasound-guided punctures can significantly reduce the rate of complications. Patients with a high risk for difficult vascular access include critical care and emergency patients as well as patients on anticoagulation medication and dialysis. Placement of central venous catheters can be difficult in ventilated patients and if there has been prior surgery in the puncture area. In children and small infants central venous access can also be challenging due to the anatomical relationship in the head and neck region. Puncture techniques are explained briefly by means of ultrasound anatomy. Typical ultrasonographic images visualize pathological findings in order to identify dangers and complications in central venous catheterization.
中心静脉置管是重症监护和围手术期医学中的一项标准操作。该操作可能会伴有严重并发症。与体表标志技术相比，超声引导下穿刺可显著降低并发症发生率。血管穿刺困难风险较高的患者包括重症监护患者、急诊患者以及正在接受抗凝治疗的患者和透析患者。对于机械通气患者以及穿刺部位曾接受过手术的患者，中心静脉导管置入可能会比较困难。在儿童和小婴儿中，由于头颈部区域的解剖关系，中心静脉通路的建立也可能具有挑战性。通过超声解剖简要解释穿刺技术。典型的超声图像可显示病理结果，以便识别中心静脉置管中的危险和并发症。
