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一种使用动脉注射静脉回血引导的婴儿股静脉穿刺新技术。

A New Technique for Femoral Venous Access in Infants Using Arterial Injection Venous Return Guidance.

作者信息

Ebishima Hironori, Kitano Masataka, Kurosaki Kenichi, Shiraishi Isao

机构信息

Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.

出版信息

Ann Vasc Dis. 2017 Mar 24;10(1):17-21. doi: 10.3400/avd.oa.16-00058. Epub 2017 Mar 31.

DOI:10.3400/avd.oa.16-00058
PMID:29034015
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5579799/
Abstract

: Although venography guidance is helpful for central venous catheter placement, it is sometimes difficult to place a peripheral intravenous cannula for enhancement. We designed a new technique for establishing femoral venous access using venography guidance in the return phase of peripheral arteriography. This new technique was named arterial injection venous return guidance. Here we assessed the efficacy and safety of arterial injection venous return guidance. : We reviewed data of 29 infants less than 6 months old undergoing catheter intervention at our institute in 2014. Of the 29 patients, femoral venous cannulation was performed using arterial injection venous return guidance in 5 patients, venography in 20 patients, and the landmark method in 4 patients. The technical success rates and incidence of complications were compared. : The overall success rates were 100% in the arterial injection venous return-guided and venography-guided groups. The mean procedure duration and mean contrast material injection time were similar between the groups. The contrast effect on the femoral vein in the arterial injection venous return-guided group was lower than that in the venography-guided group, but adequate for surgery. The overall complication rate was 17%, and obstruction of previously placed intravenous catheters was the most common complication. : Therefore, the arterial injection venous return guidance technique was as safe and efficient as venography for establishing venous access.

摘要

虽然静脉造影引导有助于中心静脉导管置入,但有时难以放置外周静脉套管用于增强。我们设计了一种在外周动脉造影回流期使用静脉造影引导建立股静脉通路的新技术。这种新技术被称为动脉注射静脉回流引导。在此我们评估了动脉注射静脉回流引导的有效性和安全性。

我们回顾了2014年在我院接受导管介入治疗的29例6个月以下婴儿的数据。在这29例患者中,5例使用动脉注射静脉回流引导进行股静脉插管,20例使用静脉造影,4例使用体表标志法。比较了技术成功率和并发症发生率。

动脉注射静脉回流引导组和静脉造影引导组的总体成功率均为100%。两组的平均手术时间和平均造影剂注射时间相似。动脉注射静脉回流引导组对股静脉的造影效果低于静脉造影引导组,但足以满足手术需要。总体并发症发生率为17%,既往放置的静脉导管阻塞是最常见的并发症。

因此,动脉注射静脉回流引导技术在建立静脉通路方面与静脉造影一样安全有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/653b/5579799/12af2b167282/avd-10-1-oa.16-00058-figure01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/653b/5579799/12af2b167282/avd-10-1-oa.16-00058-figure01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/653b/5579799/12af2b167282/avd-10-1-oa.16-00058-figure01.jpg

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本文引用的文献

1
Guidelines for performing ultrasound guided vascular cannulation: recommendations of the American Society of Echocardiography and the Society of Cardiovascular Anesthesiologists.超声引导下血管穿刺置管指南:美国超声心动图学会和心血管麻醉医师学会的建议
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用于中心静脉置管的超声定位设备:荟萃分析
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4
Peripherally inserted central catheters: guidance with use of US versus venography in 2,650 patients.外周静脉穿刺中心静脉导管:2650例患者超声引导与静脉造影引导的应用比较
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