Application of modified supra-clavicular subclavian vein puncture path in the patients with consciousness disorder / 局解手术学杂志

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.