Helmkamp B F, Sanko S R
Am J Obstet Gynecol. 1985 Dec 1;153(7):751-4. doi: 10.1016/0002-9378(85)90339-4.
Percutaneous central venous catheterization is a well-accepted procedure for cardiac monitoring, total parenteral nutrition, and long-term drug therapy. The supraclavicular approach was used for 90 catheterizations in 81 gynecologic patients to evaluate ease of insertion, complication rate, and patient compliance. Anatomic considerations, insertion technique, and the rationale for the supraclavicular approach are discussed in detail. A successful catheterization rate of 91% was achieved with acceptable morbidity. There were three instances each of pneumothorax, catheter malposition, and catheter infection. Advantages of the supraclavicular approach include a wider target area, a more direct route to the superior vena cava, and less pain on insertion. With reliable and constant landmarks, relative ease of and comfort on insertion, and low complication rate, the supraclavicular technique is the preferred method when percutaneous central venous catheterization is indicated.
经皮中心静脉置管术是一种广泛应用于心脏监测、全胃肠外营养及长期药物治疗的方法。我们采用锁骨上入路对81例妇科患者进行了90次置管，以评估置管的难易程度、并发症发生率及患者的依从性。详细讨论了解剖学因素、置管技术及锁骨上入路的理论依据。置管成功率为91%，并发症发生率可接受。气胸、导管位置不当及导管感染各发生3例。锁骨上入路的优点包括目标区域更宽、至上腔静脉的路径更直接、置管时疼痛较轻。由于标志可靠且恒定、置管相对容易且舒适、并发症发生率低，当需要行经皮中心静脉置管时，锁骨上技术是首选方法。
