国际麻醉学与复苏杂志   2021, Issue (3): 0-0
    
小儿颈内静脉置管深度研究进展
杨艳艳, 孙瑛, 张马忠1()
1.上海交通大学医学院附属上海儿童医学中心
Progress of the depth of internal jugular venous catheter in pediatric patients
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摘要:

颈内静脉(internal jugular vein, IJV)穿刺置管是临床常用技术,用于液体或药物管理,以及CVP测定等。随着小儿身高、体重的变化,IJV导管置入的合适深度也会随之发生变化。文章描述了IJV导管尖端理想位置,介绍了通过经食管超声心动图(transesophageal echocardiography, TEE)、经胸超声心动图(transthoracic echocardiography, TTE)、胸部X线检查(chest radiograph, CXR)和腔内心电图等方法确定导管尖端位置。此外,还对右侧IJV置管深度、特殊人群的IJV置管深度、左侧IJV解剖特点及置管深度进行了综述。目前已有不少计算IJV置管深度的公式,由于儿童在发育阶段存在一定的发育差异,它对于个体的适用性仍有待临床进一步考证。

关键词: 儿童; 颈内静脉; 留置导管
Abstract:

Internal jugular vein (IJV) catheterization is a common clinical technique for fluid or drug administration, as well as for central venous pressure (CVP) measurement. The optimal depth of the IJV catheter varies with the children's height and weight. This paper describes the suitable position of the catheter tip and introduces the main methods to determine the position of the catheter tip, such as transesophageal echocardiography (TEE), transthoracic echocardiography (TTE), chest radiograph (CXR) and intracanal electrocardiogram. Besides, ways to determine the appropriate depth of IJV catheters on the right or left side and depth of catheter in special populations are reviewed in this paper. There are some formulas to calculate the depth of IJV catheters. Considering the individual diversity of children, its applicability to individuals needs further clinical examination.

Key words: Child; Internal jugular vein; Indwelling catheter