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低血容量成年患者颈静脉内径的变化

Changes in the Internal Size of the Jugular Vein in Adult Patients with Hypovolemia.

作者信息

Urakov Aleksandr L, Shchegolev Aleksei V, Kasatkin Anton A, Nigmatullina Anna R

机构信息

Department of General and Clinical Pharmacology, Izhevsk State Medical Academy, Izhevsk, Russia.

Department Anesthesiology and Intensive Care, Kirov Military Medical Academy, Saint Petersburg, Russia.

出版信息

Int J Appl Basic Med Res. 2018 Jul-Sep;8(3):174-176. doi: 10.4103/ijabmr.IJABMR_277_17.

DOI:10.4103/ijabmr.IJABMR_277_17
PMID:30123748
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6082013/
Abstract

The present study is aimed at establishing the values of internal jugular vein (IJV) anterior-posterior and medial-lateral sizes in patients with hypovolemia. A total of 25 adult Intensive Care Unit patients with hypovolemia were studied. It was found that the anterior-posterior vein size in patients with hypovolemia was significantly less than medial-lateral size during inhalation and during exhalation as well ( < 0.05). Besides, the value of the anterior-posterior size (D) <7 mm was recorded in 20 from 25 patients (80%). At the same time, the medial-lateral size (D) <7 mm was recorded only in six patients (24%). In patients with hypovolemia, the medial-lateral diameter of IJV is more than its anterior-posterior diameter. These data might be useful for justifying the benefits of using lateral access for IJV catheterization under ultrasound imaging in patients with hypovolemia.

摘要

本研究旨在确定低血容量患者颈内静脉(IJV)前后径及内外径的数值。共对25例成年低血容量重症监护病房患者进行了研究。结果发现,低血容量患者在吸气及呼气时的静脉前后径均显著小于内外径(<0.05)。此外,25例患者中有20例(80%)记录到前后径(D)<7mm。同时,仅6例患者(24%)记录到内外径(D)<7mm。在低血容量患者中,颈内静脉的内外径大于前后径。这些数据可能有助于证明在超声成像引导下对低血容量患者采用颈内静脉外侧入路进行置管的益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36c5/6082013/28589846168e/IJABMR-8-174-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36c5/6082013/28589846168e/IJABMR-8-174-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36c5/6082013/28589846168e/IJABMR-8-174-g002.jpg

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本文引用的文献

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Incidence of posterior wall penetration during internal jugular vein cannulation: A comparison of two techniques using real-time ultrasound.颈内静脉置管时后壁穿透的发生率:两种实时超声技术的比较
Indian J Anaesth. 2017 Mar;61(3):240-244. doi: 10.4103/ija.IJA_632_16.
2
Using Ultrasonography to Determine Optimal Head-down Tilt Position Angle in Patients before Catheterization of the Internal Jugular Vein.使用超声检查确定颈内静脉置管术前患者的最佳头低脚高位角度
Indian J Crit Care Med. 2017 Mar;21(3):160-162. doi: 10.4103/ijccm.IJCCM_299_16.
3
Internal jugular vein cannulation without the risk of double wall punctures.
颈内静脉置管无双层壁穿刺风险。
J Emerg Trauma Shock. 2016 Oct-Dec;9(4):157. doi: 10.4103/0974-2700.193387.
4
Noninvasive intracranial pressure monitoring via optic nerve sheath diameter for robotic surgery in steep Trendelenburg position.通过视神经鞘直径进行无创颅内压监测用于陡峭头低脚高位机器人手术。
Saudi J Anaesth. 2015 Jul-Sep;9(3):239-46. doi: 10.4103/1658-354X.154693.
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Ultrasound guidance versus anatomical landmarks for internal jugular vein catheterization.超声引导与解剖标志用于颈内静脉置管的比较
Cochrane Database Syst Rev. 2015 Jan 9;1(1):CD006962. doi: 10.1002/14651858.CD006962.pub2.
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Percutaneous ultrasound-guided central venous catheters: the lateral in-plane technique for internal jugular vein access.经皮超声引导中心静脉导管置入:用于颈内静脉穿刺的外侧平面内技术。
J Vasc Access. 2014 Jan-Feb;15(1):56-60. doi: 10.5301/jva.5000177. Epub 2013 Oct 7.
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Anesthesiology. 2012 Mar;116(3):539-73. doi: 10.1097/ALN.0b013e31823c9569.
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