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 Wysłany: Śro 4:13, 02 Mar 2011 Temat postu: new balance outlet Newborn jugular vein catheteriz |
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Newborn jugular vein catheterization Applied anatomy
m03 anatomy 3.1 points lower neonatal jugular vein and the significance of this paper, the surface projection of the measured common carotid artery and the sternocleidomastoid neonatal anterior sternoclavicular joint to the intersection distance (2.8 ± 0.5) cm, total length of the sternocleidomastoid muscle (55 ± O.5) cm, the former about the latter 1 / 2, which is near the intersection in front of the midpoint of the sternocleidomastoid muscle. Neonatal vein above the clavicle from the angular position of sternoclavicular joint about 1 a lateral. Slightly lateral to the vein from the angle of the intersection to make a connection. The lower internal jugular vein is the body along the surface projection of the projection Hua puncture success rate may be higher. 3.2 The selection of the puncture site and the operating points of adult internal jugular vein site selection, Zheng Guangqi ... reported using high puncture (ie,[link widoczny dla zalogowanych], the upper edge of the hyoid bone and thyroid cartilage between the plane), but this was observed on the section of the internal jugular vein newborn and carotid artery and carotid artery in close proximity and some overlap, not puncture, and this section is close to the carotid sinus, so catheterization has some risk,[link widoczny dla zalogowanych], have been reported 【clinic. Cui Gong governance 【2 reported in the starting side two sternocleidomastoid asked puncture. Between neonates sternocleidomastoid two narrow exceptions,[link widoczny dla zalogowanych], where the internal jugular vein adjacent to the posterolateral pleural top, it is not suitable to wear the DPRK. The jugular vein and sternocleidomastoid muscle in the carotid artery Superficial anterior location of the intersection plane,[link widoczny dla zalogowanych], only covered with skin, superficial fascia and muscle, no significant around the adjacent structure. Therefore, a little outside of the intersection that should be the best at the puncture point (see Figure 1). Needle point of the depth under the venous angle (1.1cm) and the length of the lower internal jugular vein (2.7 ∞) calculated the ratio of (1.1:2.7 = O.4 = tg22o), the needle handle should be folder 22 ~ angle of the body surface, the actual operation should be slightly larger this angle, so 30 is appropriate (see Figure 2). To do the following. Prince Yu 1, A. jugular vein puncture site Ignorant of the common carotid moving front and chest intersection of the town of mastoid muscle vein puncture point B Chen №. 1T'IepLlnch blood in sacrifice siteinin-ternaljEu】 arveinA. dh ∞ which of-a-resistant i carteryandthemd port 0fBt ~ rn fan Idaua: B. 1beptmcmrekinintem ~ j Rights lveinVel ~ LlISangle prince Yu 2 puncture point of F, g. 2Theak0fp ∞ ch】 Ie children lying down, slightly under the shoulder pads, pillows, head thrown back, middle or Shaopian contralateral side. Near the midpoint of the sternocleidomastoid anterior carotid artery pulsatility touch. Pulse point is slightly outside of its puncture, the needle points to the outside of sternoclavicular joint about 1c Ⅱ. Department, the initial needle clip 30 with the skin can be angle, piercing the skin and penetrates the sternocleidomastoid muscle, the lower the needle, the needle slowly change direction,[link widoczny dla zalogowanych], to be back to the blood, stop puncture, confirmed that no errors after the perforating arteries re-intubation. 3.3 the best choice for intubation and length from Table 1, left and right internal jugular vein diameter was (5.6 ± 1.7) m and (6.5 ± 1.0) Ⅱ Ⅱ n, by testing t = 1.74, P> 0.05. No significant difference between the two, but measurement of left and right internal jugular vein and brachiocephalic vein angle sub 0 114 ~ ± 8. And 145. ± 9. 'Value is 9.7, P <0.001, significantly greater than the right side of the left. Show that the right side of the tube more easily from the jugular vein into the brachiocephalic vein. Therefore, the right internal jugular vein puncture is more suitable for clinical application should be the right choice. On the tube length can be measured under the length of the internal jugular vein, brachiocephalic vein length, the length of the superior vena cava (see Table 1 mean) calculated the sum. The length of the left tube 7.0c Ⅱ I, the right to 6.0cm. Conclusion: The neonatal section of the internal jugular vein diameter under the thick, with concomitant carotid artery adjacent to clear, less variability, with puncture of the basic conditions, according to the common carotid artery and the anterior intersection of the sternocleidomastoid muscle to determine the surface projection of the internal jugular vein easy to operate. Critical condition in newborns, consider the jugular vein cannulation, in order to save patients lives. l
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