Department of Anesthesiology, the First People's Hospital of Huzhou, the Affiliated Hospital of Huzhou Teachers College, Guangchanghou Road 158th, 313000, Huzhou, People's Republic of China.
BMC Anesthesiol. 2022 Jun 13;22(1):181. doi: 10.1186/s12871-022-01723-4.
Internal jugular vein catheterization is widely used in clinical practice, and there are many related studies on internal jugular vein catheterization. However, the omohyoid muscle, which is adjacent to the internal jugular vein, is a rarely mentioned muscle of the infrahyoid muscles group. The purpose of this study is to explore the anatomical relationship between the omohyoid muscle and the internal jugular vein on ultrasound guidance and provide a theoretical reference for jugular puncture and catheterization.
The study included 30 volunteers. The volunteer's head lay in the neutral position and was then turned to the left at an angle of 30°, 45° and 60° with the bed surface, as verified using an adjustable protractor. A high-frequency ultrasound probe (6-14 Hz) was used to examine the plane of the apex of sternocleidomastoid triangle (PAST), the triangle consists of anatomical landmarks: a base was clavicle, its sides - heads of sternocleidomastoid muscle. And the plane of the middle of sternocleidomastoid triangle(PMST) which was a horizontal line, connecting midpoints of both sides. The right omohyoid muscle (OM) and the right internal jugular vein (IJV) were observed and recorded for statistical analysis.
There were statistically significant differences in the number of overlapping cases of OM and IJV at each head rotation angle between the PAST and PMST groups. There were statistically significant differences between the angles which OM and IJV centre point line and the left horizontal position of the PAST and PMST at different body angles.
The traditional middle route puncture point is the apex of the sternocleidomastoid triangle, which can effectively avoid injury to the omohyoid muscle, to an extent.
ChiCTR2000034233 , Registered 29/06/2020. www. Chinese Clinical Trial Registry.gov.
颈内静脉置管在临床实践中应用广泛,有关颈内静脉置管的研究较多,但毗邻颈内静脉的舌骨下肌群中的胸骨舌骨肌却鲜有提及。本研究旨在探讨超声引导下胸骨舌骨肌与颈内静脉的解剖关系,为颈内静脉穿刺置管提供理论参考。
本研究纳入 30 名志愿者。志愿者头位保持中立,然后分别向左转 30°、45°和 60°,使用可调节量角器进行验证。使用高频超声探头(6-14 Hz)检查胸锁乳突肌顶点平面(PAST),该平面由解剖学标志组成:基底为锁骨,其两侧为胸锁乳突肌的头。胸骨乳突肌中间平面(PMST)为一条水平线,连接两侧中点。观察并记录右侧胸骨舌骨肌(OM)和右侧颈内静脉(IJV),并进行统计分析。
在 PAST 和 PMST 组中,每个头旋转角度的 OM 和 IJV 重叠病例数存在统计学差异。在不同体位时,OM 和 IJV 中心点连线与 PAST 和 PMST 左侧水平线的夹角存在统计学差异。
传统的中路穿刺点为胸锁乳突肌顶点,在一定程度上可以有效避免胸骨舌骨肌的损伤。
ChiCTR2000034233,于 2020 年 6 月 29 日注册,www.chictr.org.cn。