Mochida Takashi, Seino Yutaka, Matsuda Keiichiro, Haga Minako, Yamamoto Go, Moridaira Takashi, Watanabe Ippei
Department of Anesthesiology, Niigata Prefectural Central Hospital, Joetsu 943-0147.
Department of Anesthesiology, Saiseikai Niigata Daini Hospital, Niigata 950-1104.
Masui. 2014 Jan;63(1):57-61.
The safety of real-time ultrasound-guided subclavian and axillary vein cannulation as opposed to ultrasound-guided internal jugular vein cannulation has not received much attention. We retrospectively compared the safety and value of real-time ultrasound-guided cannulation in the subclavian and axillary veins with those of the landmark method.
We divided 355 patients who had undergone central venous cannulation of the subclavian and axillary vein under local anesthesia into a group that had undergone real-time ultrasound-guided cannulation (Group U), and another group cannulated using the landmark method (Group L). We compared rates of complications and cannulation success as well as average procedural durations between the two groups.
The complication rate was significantly lower in Group U (P=0.005). Most of the complications were arterial puncture. Five patients who developed pneumothorax and nerve damage were in Group L. The success rates and average procedural duration did not significantly differ.
Real-time ultrasound-guided subclavian and axillary vein cannulation is associated with a low incidence of complications similar to that of the internal jugular vein when competent individuals with appropriate training apply the technique.
与超声引导下颈内静脉置管相比，实时超声引导下锁骨下静脉和腋静脉置管的安全性尚未得到足够关注。我们回顾性比较了实时超声引导下锁骨下静脉和腋静脉置管与体表标志法置管的安全性和价值。
我们将355例在局部麻醉下接受锁骨下静脉和腋静脉中心静脉置管的患者分为实时超声引导置管组（U组）和采用体表标志法置管的另一组（L组）。我们比较了两组的并发症发生率、置管成功率以及平均操作时间。
U组的并发症发生率显著更低（P = 0.005）。大多数并发症为动脉穿刺。发生气胸和神经损伤的5例患者在L组。成功率和平均操作时间无显著差异。
当经过适当培训的有能力的人员应用该技术时，实时超声引导下锁骨下静脉和腋静脉置管的并发症发生率较低，与颈内静脉置管相似。
