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超声引导下颈内静脉穿刺置管术在介入放射学中并发气胸:4 年经验。

Pneumothorax following ultrasound-guided jugular vein puncture for central venous access in interventional radiology: 4 years of experience.

机构信息

Radiology Department, University of Massachusetts Medical School, Worcester, MA 01655, USA.

出版信息

J Intensive Care Med. 2012 Nov-Dec;27(6):370-2. doi: 10.1177/0885066611415494. Epub 2011 Jul 14.

Abstract

PURPOSE

The purpose of our study was to review the rate of pneumothorax following central venous access, using real-time ultrasound guidance.

MATERIALS AND METHODS

Data related to ultrasound-guided venous puncture, for central venous access, performed between July 1, 2004 and June 30, 2008 was retrospectively and prospectively collected. Access route, needle gauge, catheter type, and diagnosis of pneumothorax on the intraprocedure spot radiographs and or the postprocedure chest radiographs, were recorded.

RESULTS

A total of 1262 ultrasound-guided jugular venous puncture for central venous access were performed on a total of 1066 patients between July 1, 2004 and June 30, 2008. Access vessels included 983 right internal jugular veins, 275 left internal jugular veins, and 4 right external jugular veins. No pneumothorax (0%) was identified.

CONCLUSION

Due to an extremely low rate of pneumothorax following ultrasound-guided central venous access, 0% in our study and other published studies, we suggest that routine postprocedure chest radiograph to exclude pneumothorax may be dispensed unless it is suspected by the operator or if the patient becomes symptomatic.

摘要

目的

本研究旨在回顾使用实时超声引导进行中心静脉置管后气胸的发生率。

材料与方法

回顾性和前瞻性收集了 2004 年 7 月 1 日至 2008 年 6 月 30 日期间行超声引导下静脉穿刺置管术用于中心静脉置管的数据。记录了置管途径、针号、导管类型以及术中即时 X 线片或术后胸部 X 线片上气胸的诊断。

结果

2004 年 7 月 1 日至 2008 年 6 月 30 日期间,共有 1066 例患者共进行了 1262 例超声引导下颈内静脉穿刺置管术。置管血管包括 983 例右侧颈内静脉、275 例左侧颈内静脉和 4 例右侧颈外静脉。无一例气胸(0%)。

结论

由于超声引导下中心静脉置管后气胸发生率极低,本研究中为 0%,其他已发表的研究中也为 0%,因此我们建议除非操作者怀疑或患者出现症状,否则可以不常规行术后胸部 X 线片以排除气胸。

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