Weber D, Wittig D, Uhlmann B, Reinhardt G, Baumann G
Z Gesamte Inn Med. 1975 Aug 15;30(16):148-53.
It is reported on the infusion, stimulation and microcatheter technique in an internal intensive therapy ward. From July 1st 1970 to November 11th 1974 were altogether laid 1,642 superior cavacatheters, 1,057 times by puncture of the subclavian vein and 585 times through the brachial veins. Compared with the usual infusion techniques the advantages of the cava-catheter technique consist in the fact that a constant venous approach is existing and that solutions of a high percentage and medicaments may be infused relatively undangerously. Apart from this the cava-catheter gives the possibility to carry out continuous measurements of the central venous pressure and guarantees the taking of blood samples at any time. The phlebitides or thromboses, respectively, which are regularly appearing in flexules lying longer than 40 hours are avoided in most cases. Taking into consideration the contraindications and the exact performance of the various methods especially early complications such as puncture of the arteries, pneumothorax, detachment of the catheter, extended haematomas and wrong positions of the catheter may be reduced to a minimum. As late complications distinct infections in the place of puncture, unclear, partly septic temperatures and clinically manifest thromboses were observed. In these cases the cava-catheters should be removed. The temporary electrostimulation through electrode catheters plays an important part in the emergency medicine and the mastering of the various methods of the cava-catherization is taken for granted. During the period of report altogether 423 stimulation catheters were laid. The cardiac microcatheterization should be reserved for more special cases.
本文报道了内科重症监护病房的输液、刺激及微导管技术。1970年7月1日至1974年11月11日期间,共置入1642根上腔静脉导管,其中经锁骨下静脉穿刺1057次,经肱静脉穿刺585次。与常规输液技术相比,腔静脉导管技术的优点在于有恒定的静脉通路,高浓度溶液和药物可相对安全地输注。除此之外,腔静脉导管还能持续测量中心静脉压,并保证随时采集血样。多数情况下可避免因输液时间超过40小时而经常出现的静脉炎或血栓形成。考虑到各种方法的禁忌证及正确操作,尤其是早期并发症,如动脉穿刺、气胸、导管脱落、广泛血肿及导管位置错误等,可降至最低限度。作为晚期并发症,观察到穿刺部位明显感染、不明原因的部分发热及临床明显的血栓形成。在这些情况下,应拔除腔静脉导管。通过电极导管进行的临时电刺激在急诊医学中起重要作用,掌握各种腔静脉置管方法是理所当然的。在报告期间,共置入423根刺激导管。心脏微导管检查应留用于更特殊的病例。