改良平肩水平式锁骨下静脉穿刺术的分析.pdf

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1、·临床研究·2011年9月第49卷第26期改良平肩水平式锁骨下静脉穿刺术的分析吴群英（广东省江门市中心医院手术室，广东江门529031）[摘要]目的探讨锁骨下静脉穿刺采用平肩水平式贴锁骨下进针的方法与效果及并发症。方法择期手术病例500例，随机分为实验组和对照组各250例。实验组锁骨下静脉穿刺方法是改良平肩水平式锁骨下静脉穿刺术；对照组锁骨下静脉穿刺是采用传统的一般锁骨下静脉穿刺术。结果实验组采用改良平肩水平式贴锁骨下进针方法穿刺成功232例，成功率为92.8%；而对照组采用常规传统方法进行穿刺成功为199例，成功率79.6%。实验组与对照组锁骨下静脉穿刺方法

2、比较具有显著性差异（P＜0.05）。对照组并发症发生率较高，锁骨下静脉穿刺过程发生气胸18例，误伤锁骨下动脉25例，血气胸3例，纵膈血肿1例，皮下气肿2例；而实验组锁骨下静脉穿刺过程发生气胸仅3例，误伤锁骨下动脉为7例，并发症发生率实验组与对照组比较差异具有显著性（P＜0.05）。结论改良平肩水平式贴锁骨下进行锁骨下静脉穿刺方法可行，安全、成功率高，并发症发生率低，容易掌握和操作，可在临床上推广应用。[关键词]平肩；锁骨下静脉；穿刺[中图分类号]R61[文献标识码]B[文章编号]1673-9701（2011）26-28-03TheAnalysisofImpro

3、vingHorizontalandFlatShoulderSubclavianVeinPunctureWUQunyingTheOperatingRoomofCentralHospitalofJiangmeninGuangdong，Jiangmen529031，China[Abstract]ObjectiveToinvestigatetheuseofsubclavianveinpunctureflatshoulderhorizontalneedleattachedsubclavianapproachwiththeeffectsandcomplications.M

4、ethodsAll500casesofelectivesurgerypatientswererandomlydividedintoexperimentalandcontrolgroupof250cases.Subclavianveinthroughtheexperimentalgroupbenefitisimprovedflathorizontalshouldersubclavianveinpuncture.Controlgroupsubclavianveinpunctureiscommonlyusedintraditionalgeneralsubclavia

5、nveinpuncture.ResultsThemodifiedflathorizontalshoulderpastemethodofsubclavianpunctureneedle232casesofsuccess，thesuccessrateof92.8%.Whilethecontrolgroupusingconventionalmethodsofsuccessfulpuncturetraditional199cases，thesuccessrateof79.6%.Experimentalgroupandcontrolgroupsubclavianvein

6、puncturemethodisasignificantdifference（P＜0.05）.Conclusionratecontrolgroupthehighestincidenceofsubclavianveinpunctureandpneumothoraxoccurredduring18casesofaccidentalinjuryofthesubclavianarteryin25cases，pneumothoraxin3cases，mediastinalhematoma，subcutaneousemphysemain2cases.Theexperime

7、ntalgroupsubclavianveinpunctureoccurredduringonly3casesofpneumothorax，accidentalinjuryofthesubclavianarteryin7cases.Complicationrateexperimentalgroupandcontrolgroupdifferencewassignificant（P＜0.05）.ConclusionThemodifiedflathorizontalshoulderpastesubclavianpuncturethesubclavianveinpun

8、cturemethodisfeasib