Maffessanti M, Bortolotto P, Kette F
Istituto di Radiologia, Università, Trieste.
Radiol Med. 1988 Jun;75(6):609-12.
Malpositions and complications following central venous catheterization largely depend on the site of venous approach. Malpositions are very common after subclavian vein catheterization, and even more common after left jugular vein catheterization. On the contrary, their incidence after right jugular puncture is very low. Among complications, pneumothorax is quite common after subclavian vein catheterization, and migration of the catheter towards the heart after right jugular puncture. Vascular damages may occur in any approach: their early detection on chest radiographs very much depends on a rigorous technique. Radiology plays an important role in the early detection of malpositions and complications, which is greatly facilitated by a few ml of contrast medium injected through the catheter.
中心静脉置管后的位置异常和并发症很大程度上取决于静脉入路部位。锁骨下静脉置管后位置异常非常常见，左颈内静脉置管后更常见。相反，右颈内静脉穿刺后其发生率非常低。在并发症中，锁骨下静脉置管后气胸相当常见，右颈内静脉穿刺后导管向心脏移位。任何入路都可能发生血管损伤：在胸部X线片上早期发现它们很大程度上取决于严格的技术。放射学在位置异常和并发症的早期发现中起重要作用，通过导管注入几毫升造影剂可极大地促进这一过程。
