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颈内静脉置管:心脏手术中的标志性技术与超声引导技术对比

Internal Jugular Vein Catheterization: The Landmark Technique versus Ultrasonography Guidance in Cardiac Surgery.

作者信息

Kayir Selcuk, Ozyalcin Sertan, Dogan Guvenc, Diken Adem Ilkay, Turkmen Ufuk

机构信息

Anesthesiology, Hitit University Erol Olcok Training and Research Hospital, Corum, TUR.

Cardiovascular Surgery, Hitit University Erol Olcok Training and Research Hospital, Corum, TUR.

出版信息

Cureus. 2019 Feb 7;11(2):e4026. doi: 10.7759/cureus.4026.

Abstract

Background Central venous catheterization is an invasive procedure that must be performed during cardiovascular surgery. The addition of ultrasound guidance to the catheterization technique has shown effectiveness in reducing complications because it allows for the visualization of anatomical variations prior to intervention and the continual visualization of the needle during the placement. The purpose of this study was to evaluate the effectiveness of needle-guiding ultrasound for internal jugular venous cannulation. Method Patients undergoing coronary bypass surgery at Hitit University, department of cardiovascular surgery, from January 2014 to June 2018, were included in the study. The patients were divided into two groups: those with catheterization with ultrasound guidance (Group U) and those with catheterization performed with the anatomic landmark technique (Group L). Results A total of 584 cases were investigated. The success of the procedure and complication rates for both methods were compared. Central vein catheterization with ultrasonography produced success and complication rates significantly better than those for catheterization using the landmark technique (p=0.04 and p=0.00001, respectively). Conclusion This study demonstrated that the use of ultrasonography for internal jugular vein catheterization for patients undergoing coronary bypass surgery significantly reduced the complication rates as compared to those of patients where the landmark technique was used for catheterization.

摘要

背景

中心静脉置管是心血管手术中必须进行的侵入性操作。在置管技术中增加超声引导已显示出在减少并发症方面的有效性,因为它能在干预前可视化解剖变异,并在置管过程中持续可视化针头。本研究的目的是评估针引导超声用于颈内静脉置管的有效性。方法:纳入2014年1月至2018年6月在希提特大学心血管外科接受冠状动脉搭桥手术的患者。患者分为两组:超声引导下置管组(U组)和采用解剖标志技术置管组(L组)。结果:共调查584例病例。比较了两种方法的操作成功率和并发症发生率。超声引导下中心静脉置管的成功率和并发症发生率明显优于采用标志技术置管(分别为p = 0.04和p = 0.00001)。结论:本研究表明,与采用标志技术置管的患者相比,冠状动脉搭桥手术患者使用超声引导进行颈内静脉置管可显著降低并发症发生率。

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