首都医科大学学报 ›› 2007, Vol. 28 ›› Issue (3): 409-411.

• 临床研究 • 上一篇    下一篇

中心静脉导管准确定位在坐位神经外科手术中的应用

马挺, 蔡兵, 兰飞, 魏立民, 王克杰   

  1. 首都医科大学宣武医院麻醉科
  • 收稿日期:2006-08-24 修回日期:1900-01-01 出版日期:2007-06-24 发布日期:2007-06-24

Accurate Placement of Central Venous Catheters in Sitting Position Neurosurgical Operation

Ma Ting, Cai Bing, Lan fei, Wei Limin, Wang Kejie   

  1. Department of Anesthesiology, Xuanwu Hospital, Capital Medical University
  • Received:2006-08-24 Revised:1900-01-01 Online:2007-06-24 Published:2007-06-24

摘要: 目的 利用心内心电图引导中心静脉导管准确定位,观察坐位手术中吸除气体栓子的效果。方法 13例坐位手术患者,利用中心静脉导管导引钢丝作为心内电极,拾取心内心电信号,通过观察心电图波形判断导管尖端的位置,与手术后X线胸片比较,对比特异度。监测到气体栓子时抽吸中心静脉导管,观察有无气体以及气体的量。结果 利用心电图原理放置导管的准确率与手术后胸片对照特异度为100%;13例中有7例监测到气体栓子,气体抽吸的成功率为100%,抽吸到的气体量0.5~20mL。结论 利用心电图波形引导可准确定位中心静脉导管尖端位置,并能有效吸除栓塞气体。

关键词: 中心静脉导管, 心内心电图, 坐位手术, 气栓

Abstract: Objective To place the central venous catheters accurately guided by the intracardic electrocardiography(ECG) and investigate the effects of aspirating air embolus in sitting position neurosurgical operation.Methods Thirteen sitting operation patients who received a central venous catheter to aspirate air embolus were enrolled.The central venous catheter was accurately placed by using guiding wire as internal electrode to record intracardiac signals.The position of the catheter was assessed through the changes in intracardiac ECG and re-checked with X-rays after operation.When air embolus was detected,it was aspirated through the central venous catheter and the volume of air calculated.Results The technique of using intracardiac ECG to guide the placement of central venous catheter was accurate.Seven air emboli were detected in 13 patients.The success rate of aspiration was 100% and the volumes of aspirated air were from 0.5~20 mL.Conclusion The technique of using intracardiac ECG guidance to detect central venous catheter tip is convenient and accurate;Air embolus can be aspirated effectively.

Key words: central venous catheter, endocavitary electrocardiography, sitting operation, air embolus

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