Armstrong P J, Sutherland R, Scott D H
Department of Anaesthesia, Edinburgh University, Royal Infirmary of Edinburgh, Scotland, U.K.
Acta Anaesthesiol Scand. 1994 Apr;38(3):229-31. doi: 10.1111/j.1399-6576.1994.tb03879.x.
Internal jugular vein (IJV) cannulation is a popular approach for central venous access as it has few complications, of which failure to locate the vein and carotid artery puncture are the most common. A variety of manoeuvres and body positioning has been used to maximise IJV size and thereby increase cannulation success rate and decrease complications. Realtime 2D ultrasound can be used to view neck vascular anatomy in vivo and allow IJV size to be measured. Thirty-five volunteers had the lateral diameter of their IJV measured using the SiteRite ultrasound machine to discover the most effective methods of increasing its diameter. No correlation was found between the IJV lateral diameter and subject height, weight, age or neck circumference. Carotid artery palpation and full neck extension reduced its diameter considerably. Increasing Trendelenberg increased diameter. Abdominal binder and the Valsalva manoeuvre were the most efficient methods of increasing its size.
颈内静脉插管是一种常用的中心静脉通路建立方法，因为其并发症较少，其中最常见的是静脉定位失败和颈动脉穿刺。人们采用了各种手法和体位来最大化颈内静脉的尺寸，从而提高插管成功率并减少并发症。实时二维超声可用于在体内观察颈部血管解剖结构，并测量颈内静脉的尺寸。35名志愿者使用SiteRite超声仪测量了其颈内静脉的外径，以找出增加其直径的最有效方法。未发现颈内静脉外径与受试者的身高、体重、年龄或颈围之间存在相关性。颈动脉触诊和颈部完全伸展可使其直径显著减小。增加头低脚高位可增加直径。腹部束带和瓦尔萨尔瓦动作是增加其尺寸的最有效方法。
