Gordon A C, Saliken J C, Johns D, Owen R, Gray R R
Department of Radiology, Foothills Hospital, Calgary, Alberta, Canada.
J Vasc Interv Radiol. 1998 Mar-Apr;9(2):333-8. doi: 10.1016/s1051-0443(98)70277-5.
To examine success and complication rates for ultrasound (US)-guided cannulation of the internal jugular vein (IJV) in comparison with blind techniques and to present the variations in anatomy of the IJV.
Data were prospectively collected for 869 cases of sonographically guided cannulation of the IJV. In all cases, the side of the puncture, procedural success or failure, and any immediate complications were recorded. In 764 (88%) cases, the number of passes required and whether a single- or double-wall puncture was used were recorded. In 690 (79%) cases, IJV diameter and depth were recorded, while its relationship to the common carotid artery (CCA) was noted in 659 (76%) cases.
Cannulation was successful in 868 (99.9%) cases. Complications occurred in 20 (2.3%) cases. Eighty-seven percent of cannulations were achieved with one pass and 83% with a single-wall puncture. Success at first pass was significantly correlated with right-sided puncture and the diameter of the IJV. In 5.5% of cases, the IJV lay medial to the CCA, making successful cannulation with use of the landmark technique unlikely.
US-guided cannulation of the IJV is superior to blind techniques, increasing the success rate and incidence of first pass cannulation and reducing the incidence of complications.
与盲穿技术相比，研究超声（US）引导下颈内静脉（IJV）置管的成功率和并发症发生率，并阐述IJV的解剖变异。
前瞻性收集869例超声引导下IJV置管的数据。记录所有病例的穿刺侧、操作成功或失败情况以及任何即刻并发症。在764例（88%）病例中，记录所需穿刺次数以及采用单壁还是双壁穿刺。在690例（79%）病例中，记录IJV的直径和深度，在659例（76%）病例中记录其与颈总动脉（CCA）的关系。
868例（99.9%）置管成功。20例（2.3%）出现并发症。87%的置管一次成功，83%采用单壁穿刺。首次穿刺成功与右侧穿刺及IJV直径显著相关。在5.5%的病例中，IJV位于CCA内侧，采用体表标志技术难以成功置管。
US引导下IJV置管优于盲穿技术，可提高首次穿刺置管的成功率和发生率，并降低并发症发生率。
