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作者采用直线型电子扫描超声波引导,施行颈内静脉穿刺、中心静脉插管术,效果良好。对象:以消化道手术患者18例为治疗对象,平均年龄56岁,身高160cm,体重54kg。方法:器械为1.线型电子扫描超声波,探头频率波数5MHz。2.穿刺用套管针一套(12G、14G、16G)。3.外科清洁巾单。步骤为患者仰卧、抬高颈部,头左偏(一般选用右侧颈内静脉),消毒皮肤铺巾单,皮肤涂以耦合剂,用超声波探头在锁骨与胸锁乳突肌胸骨部、锁骨部形成的三角区内探查,颈内静脉及颈总动脉即可显象。颈内静脉一般平行贴靠于颈总动脉外侧,血管壁薄,内腔大,轻度压迫即可使血管变得扁平;而动脉壁厚,压迎后内腔几乎无变化,并可见搏动,可资二者区别。使用小探头时,用左手持探头,尽量从锁骨外侧探查,防止血管腔受压变形。探头游走探查出颈内静脉后,即在探头正前方1cm 处用22G针头局部麻醉,根据颈内静脉超声波断层像及针头影
The author uses linear electronic scanning ultrasound guidance, the implementation of internal jugular vein puncture, central venous catheterization, the effect is good. PARTICIPANTS: Eighteen patients with gastrointestinal surgery were treated, with an average age of 56 years, a height of 160 cm and a weight of 54 kg. Methods: Instruments for 1. Linear electronic scanning ultrasound, the probe frequency wave number 5MHz. 2. Puncture with a trocar (12G, 14G, 16G). 3. Surgical cleaning sheets. The steps for the patient supine, raise the neck, head left (usually the right side of the jugular vein), disinfect the skin shop towels, the skin coated with couplant, Department of Triangle formed within the probe, jugular vein and common carotid artery can be visualized. Internal jugular vein generally parallel to the external side of the common carotid artery, thin wall, lumen, mild oppression can make the blood vessels become flat; and arterial wall thickness, after the compression of the lumen almost no change, and visible beats, Can be the difference between the two. When using a small probe, hold the probe with your left hand as far as possible from the outside of the clavicle to prevent compression of the vessel lumen. After the probe probe to explore the internal jugular vein, that is, 1cm in front of the probe with 22G needle local anesthesia, according to the jugular vein ultrasound tomography and needle shadow