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A new method of subclavian vein puncture and clinical application


--~--- A subclavian subclavian vein catheterization Road probe intravenous tube is parenteral nutrition central venous pressure measurement and exploration is one important means. Shouted vein subclavian vein is a continuation. From the lateral edge of the first rib. Adults of about 3 ~ 4cm, in front of the subclavian vein within a margin of f,[link widoczny dla zalogowanych], the following is the first rib,[link widoczny dla zalogowanych], followed by anterior scalene muscle. Subclavian vein in the mid-point over the first rib on the inner side surface of light up in the bow, and then inward, the next. Slightly forward over the bone before the oblique muscle, and jugular vein confluence. Clavicle was ~ shaped curve. Palpable in the body surface to the length of the clavicle and the sternum within the inverted half-angle. 1 to 6 fatty pectoralis major attached on the cartilage, a deltoid muscle attached to the clavicle, the collarbone down half the lower edge of outer. Lateral border of pectoralis major and the deltoid muscle is a distinct component within the inverted triangle edge of Waterloo,[link widoczny dla zalogowanych], also known as the subclavian fossa, surface palpation found clavicle from the outside. Gradually from a wide coarse were thin. ~ Shaped bend in the middle of bias. There is a distinct notch. Or concave hidden, this point is the subclavian fossa below the top of this point as the subclavian vein subclavian puncture way point. (Figure 1,2) in 2 - Clinical Technology ways the three groups Table 1 success rate, complication rate compared with group A,[link widoczny dla zalogowanych], group B compared. 'P <005 a P <001 of 150 down to adult patients. Divided into three groups. Group A: the clavicle, the outer 1 / 3 point of intersection as the puncture point at the bottom of lcm; Group 13: clavicle in the t / 3 junction points as the puncture point at the bottom of lcra; group c: to the top of the subclavian fossa. Lcm at the bottom of the clavicle. As the puncture point. Patients taking the first low of 15 degrees. Slightly elevate the upper body, head to the opposite side, as drooping upper end to the foot, one-person operation by a special set by positioning the above three positioning methods. Direction to point along the lower edge of the clavicle or sternum on the nest thyroid cartilage, while the needle side Withdrawing. Blood back to the rear guide wire. After the catheter. If the Group A and Group B Group C puncture method fails to switch to puncture. Analysis of three success rate of a needle puncture, repeated the success rate of puncture, pneumothorax complications. Test for statistical analysis using, P <0.05 as significant difference. Group C results and repeated the success rate of a needle puncture success rate was significantly higher than group A and group B. No complications. Group A and group B and repeated the success rate of a needle puncture success rate is not significantly different. Incidence of complications was no significant difference. Table 1. The traditional way to discuss the subclavian subclavian vein puncture Author: Shiyan City, Hubei 442008 Beam Center Hospital of wind companies choose foreign clavicle 1 / 3 or in the l / 3 of about lcm below the needle. As the positioning quantified clear sign of failure to clinical palpation subclavian needle, and sometimes need to repeatedly puncture. More complications. There is a certain failure rate, compared with the clinical use of this method step, so that needle into the subclavian Road, clinical application is limited. According to the structure of the clavicle and the surrounding anatomy. Found beneath the lateral border of the clavicle, between the lateral border of pectoralis major was called a triangle subclavian fossa slightly concave, and in this depression in the top and bottom of the clavicle over the subclavian vein is the location of the first rib, clavicle and first rib while the spacing between the relatively wide, this point of puncture, both easy to pass the lower edge of the clavicle, met the first rib are more steps, because they do not cross the first rib, worn very little chance of pleural . Clinical trial results showed that: this method is superior to the traditional position. Success rate of a needle. Fewer complications. Value is the clinical reference and promotion.
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