Hospices Civils de Lyon, Groupement Hospitalier Est, Hôpital Neurologique Pierre Wertheimer, Service d'Anesthésie Réanimation, 59 boulevard Pinel, Bron 69677, Cedex, France.
Br J Anaesth. 2014 May;112(5):879-84. doi: 10.1093/bja/aet482. Epub 2014 Feb 10.
The aim of our study was to describe the anatomic relationships in internal jugular (IJV), subclavian (SCV), and femoral (FV) vein sites.
One hundred and forty-two children had a two-dimensional (2D) ultrasound (US) evaluation of IJV, SCV, and FV sites. They were enrolled according to their age: 0-1 month old (n=9), 1 month old to 2 yr old (n=61), 2-6 yr old (n=22), 6-12 yr old (n=32), and 12-18 yr old (n=18).
We found about 7.7% variation for the IJV. The most common anatomic variations were a lateral (nine children) or anterior (nine children) position of the IJV to the carotid artery. Regardless of the age category, about 9.8% of the anatomic variations were found for the FV. The most common anatomic variation in our study was that the FV ran anteromedially to the femoral artery (17 children). Anatomic variation of the SCV, regardless of age category, was about 7.4%. The most common anatomic variation was the SCV, which ran medially (10 children) to the subclavian artery.
The relevant percentages of anatomic variations obtained for all these areas support at least a systematic US screening before attempting to obtain central venous access, ideally using a US-guided technique.
本研究的目的是描述颈内静脉（IJV）、锁骨下静脉（SCV）和股静脉（FV）部位的解剖关系。
142 名儿童接受了 IJV、SCV 和 FV 部位的二维（2D）超声（US）评估。根据年龄将他们纳入研究：0-1 个月（n=9）、1 个月至 2 岁（n=61）、2-6 岁（n=22）、6-12 岁（n=32）和 12-18 岁（n=18）。
我们发现 IJV 存在约 7.7%的变异。最常见的解剖变异是 IJV 位于颈动脉的外侧（9 名儿童）或前侧（9 名儿童）。无论年龄组如何，FV 的解剖变异约为 9.8%。在我们的研究中，最常见的解剖变异是 FV 沿股动脉的前内侧走行（17 名儿童）。SCV 的解剖变异，无论年龄组如何，约为 7.4%。最常见的解剖变异是 SCV 沿锁骨下动脉走行（10 名儿童）。
所有这些部位获得的解剖变异的相关百分比均支持至少在尝试获得中心静脉通路之前进行系统的 US 筛查，理想情况下使用 US 引导技术。
