Goetting M G, Preston G
Department of Pediatrics, Henry Ford Hospital, Detroit, MI 48202.
Crit Care Med. 1990 Nov;18(11):1220-3. doi: 10.1097/00003246-199011000-00006.
Jugular bulb catheterization (JBC) provides cerebral venous access for titration of brain-specific therapy. Little has been written about the catheterization procedure. We prospectively studied the time, number of punctures, success rate, and complications during JBC for a 24-month period in our ICUs. One hundred twenty-three patients (mean age 6.7 yr, range 12 hours to 21 yr) underwent JBC. Procedure time was 15.6 +/- 5.0 (SD) min. Median number of skin punctures was two. All but four were successful on first attempt. Three of the remaining were catheterized on second attempt. Inadvertent carotid puncture occurred in 3%. No other significant complications were noted. Radiography confirmed proper position in 97%. Duration of indwelling venous catheters was 2.5 +/- 1.6 days. All catheters functioned well until removal. We conclude that our technique of JBC is safe and highly successful. It compares favorably with previous, smaller series and with standard anterograde internal jugular catheterization in both children and adults.
颈静脉球导管插入术（JBC）为脑部特异性治疗的滴定提供了脑静脉通路。关于该导管插入术的相关文献较少。我们对重症监护病房（ICU）中24个月内JBC操作的时间、穿刺次数、成功率及并发症进行了前瞻性研究。123例患者（平均年龄6.7岁，范围12小时至21岁）接受了JBC。操作时间为15.6±5.0（标准差）分钟。皮肤穿刺的中位数为两次。除4例之外，其余均首次尝试成功。其余患者中有3例在第二次尝试时成功插入导管。3%的患者发生了意外的颈动脉穿刺。未发现其他显著并发症。X线检查证实97%的导管位置正确。留置静脉导管的时间为2.5±1.6天。所有导管在拔除前功能良好。我们得出结论，我们的JBC技术安全且成功率高。与之前较小样本量的系列研究以及儿童和成人的标准顺行性颈内静脉导管插入术相比，效果良好。
