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目的了解严重多发伤患者颈内静脉粗细和影响因素,为提高颈内静脉置管成功率提供指导。方法超声检测50例多发伤患者和27例正常人吸气末、呼气末的颈内静脉截面积,比较2组颈内静脉粗细、影响因素及优势静脉分布情况。结果多发伤患者颈内静脉较对照组增粗,每侧有3例截面积＜0．40cm~2,优势静脉位于右、左侧分别为37例和13例,与对照组比较,差异无统计学意义。正常组颈内静脉粗细与年龄、身高、体重有关,多发伤患者则与中心静脉压、机械通气相关。结论多发伤患者双侧颈内静脉不对称,较正常人增粗,穿刺前超声探查和穿刺时使用呼吸机吸气暂停功能有助于提高颈内静脉置管成功率。
Objective To understand the thickness and influencing factors of internal jugular vein in patients with severe multiple trauma and provide guidance for improving the success rate of internal jugular vein catheterization. Methods Fifty patients with multiple traumatic injury and 27 normal subjects were inspected by end-inspiratory, end-expiratory internal jugular vein ultrasonography. The thickness, influencing factors and superior venous distribution of the internal jugular vein in two groups were compared. Results The jugular vein in patients with multiple trauma was thicker than the control group. There were 3 cases of cross-sectional area <0.40cm ~ 2 on each side, 37 cases on the right side and 13 cases on the left side, respectively, with no statistical difference Significance of learning. The normal group of internal carotid artery thickness and age, height, weight related to multiple trauma patients with central venous pressure, mechanical ventilation related. Conclusions Bilateral venous internal jugular vein asymmetry in patients with multiple traumatic injury is thicker than that in normal people. Ultrasound examination before puncture and puncturing with ventilator inspiratory suspension help to improve the success rate of internal jugular vein catheterization.