ABSTRACT
Objective To compare the practicability, reliability and safety of three paths of central venous puncture,namely internal jugular vein,modified supra-clavicular subclavian vein and subclavian vein,for patients with consciousness disorder.Methods The clinical data of 135 patients with consciousness disorder in department of neurology were retrospectively analyzed.These patients were comprised of 40 cases of internal jugular vein puncture(group J),58 cases of modified supra-clavicular subclavian vein puncture(group GS)and 37 cases of subclavian vein puncture(group S).The one-time success rate,total success rate,puncture and catheterization time and complications were compared among the three groups.Results The one-time success rate of group GS(89.7%)was higher than that of group J(77.5%)and group S(59.5%)with significant difference(P<0.05).There was no significant difference in the total success rate between group GS (94.8%)and group J(87.5%)(P>0.05),but they were higher than that of group S(70.3%)with significant difference(P<0.05). The puncture and catheterization time in group GS was shorter than that of group J and group S with significant difference(P<0.05).The to-tal incidence of complications of group GS(5.2%)was lower than that of group J(20%)and group S(29.7%)with significant difference (P<0.05).Conclusion Compared to internal jugular vein and subclavian vein, the modified supra-clavicular subclavian vein puncture path can adapt to more body positions,improve success rate and reduce complications in patients with consciousness disorder.
ABSTRACT
Objective To compare the advantages and disadvantages of internal jugular vein and subclavian vein puncture approach by clinical and anatomical ways so as to explore the best way of establishing a central venous access to guide clinical work .Methods The 120 patients who were admitted into our hospital from January 2014 to January 2016 were randomly divided into the internal jugular vein group and the subclavian vein group with 60 cases in each group according to puncture approach , and the puncture were operated by the same group of physicians .The learning curve ,puncture success rate ,completion time ,complication rates and other indicators of the two groups were evalua-ted.Results The operating completion time of internal jugular vein puncture group was (22.00 ±5.58)minutes,the success rate was 52%, the learning curve was 12 cases;while the subclavian vein puncture group was (11.60 ±2.67)minutes,93% and 3 cases respectively,and the differences were statistically significant between the two groups (P<0.05).The total complication rate of the internal jugular vein punc-ture group was 58%while the subclavian vein group was 12%, and the difference was statistically significant (P<0.05).Conclusion Dif-ficulty,safety and complication rates of subclavian vein puncture approach were better than those of the internal jugular vein puncture ap -proach.Therefore, subclavian vein puncture approach should be the first choice when there’s a need to establish central venous access for rescuing severe patients such as shock .