Page B, Souissi M, Legendre C, Moreau J F
Service de Réanimation et Transplantation, Hôpital Necker, Paris.
Nephrologie. 1994;15(2):111-2.
Despite significant progress, vascular access remains a major concern for nephrologists. For the last 6 years we have used as temporary vascular access silastic twin catheters implanted into the internal jugular vein based on Canaud's method. We have developed in 15 patients an ultrasound-guided method using an ultrasonic Doppler to improve access to the internal jugular vein, prior to its catheterization. Ultrasound assistance was provided by a 5MHz mechanical sectorscanning transducer (Toshiba 270A). The internal jugular vein and carotid artery were visualized. The skin overlying the internal jugular vein was marked with indelebile ink. The internal jugular vein was cannulated successfully in 14 patients. The use of ultrasound guidance to cannulate the internal jugular vein improves success, and reduces complications. This method is recommended in patients with distorted cervical or subclavicular anatomic characteristics, or with bleeding tendency.
尽管取得了显著进展，但血管通路仍然是肾脏病学家主要关注的问题。在过去6年里，我们一直根据卡诺德方法，将硅橡胶双腔导管植入颈内静脉作为临时血管通路。我们为15例患者开发了一种超声引导方法，即在颈内静脉插管前，使用超声多普勒改善对颈内静脉的穿刺。超声辅助由一个5MHz机械扇形扫描换能器（东芝270A）提供。颈内静脉和颈动脉得以可视化。颈内静脉上方的皮肤用不易褪色的墨水标记。14例患者颈内静脉插管成功。使用超声引导进行颈内静脉插管可提高成功率并减少并发症。对于颈部或锁骨下解剖特征扭曲或有出血倾向的患者，推荐使用这种方法。
