Alderson P J, Burrows F A, Stemp L I, Holtby H M
Department of Anaesthesia, Hospital for Sick Children, Toronto, Ontario, Canada.
Br J Anaesth. 1993 Feb;70(2):145-8. doi: 10.1093/bja/70.2.145.
Percutaneous cannulation of the internal jugular vein in paediatric patients may be technically difficult and is prone to complications. To investigate the possibility that anatomical factors contribute to these difficulties, we used a two-dimensional ultrasound scanner to examine venous anatomy in children aged up to 6 yr. We found that 18% of our children had anomalous venous anatomy that may account for some of the difficulties reported previously. The diameter of the internal jugular vein was predicted poorly by the patient's age (r2 = 0.259) or weight (r2 = 0.155). We also evaluated the use of this ultrasound scanner during percutaneous central venous cannulation in neonates and infants. Determining the course of the internal jugular vein with the scanner and then marking it on the overlying skin reduced both the time and number of needle insertions required to aspirate jugular venous blood and increased the chance of a complication-free cannulation.
小儿患者经皮颈内静脉插管在技术上可能有难度，且容易出现并发症。为了研究解剖因素导致这些困难的可能性，我们使用二维超声扫描仪检查了6岁及以下儿童的静脉解剖结构。我们发现，18%的儿童存在异常静脉解剖结构，这可能是先前报道的一些困难的原因。颈内静脉直径与患者年龄（r2 = 0.259）或体重（r2 = 0.155）的相关性较差。我们还评估了这种超声扫描仪在新生儿和婴儿经皮中心静脉插管过程中的应用。用扫描仪确定颈内静脉走行，然后在其上方皮肤做标记，减少了抽取颈静脉血所需的时间和穿刺次数，并增加了无并发症插管的几率。
