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The aim of the present study was to ultrasound imaging observation through the structure of the internal jugular vein and surrounding tissue by sternocleidomastoid the outside edge of the line of the internal jugular vein puncture catheter imaging data, while looking for a relatively ideal puncture postural and parts; and its clinical application and provide the basis for its feasibility, safety. This study consists of two parts. The first part (ultrasound imaging study): 80 cases of adult volunteers, 43 males and 37 females, Terason2000 portable B-device, respectively, in three different head position, three different anatomical horizontal plane, observation and determination of the right side of the neck overlap rate of the vein and the carotid artery, jugular vein internal diameter and the outer edge to the sternocleidomastoid lateral border of the skin distance, and the results were statistically analyzed to find out by sternocleidomastoid lateral border internal jugular vein catheterization ideal the puncture head position and posture. Part II (clinical research): 180 cases of elective surgery patients, male 93 cases, female 87 cases, ASA Ⅰ ~ Ⅱ grade, line the right internal jugular vein catheterization. Were randomly divided into 2 groups, 90 cases in each group, the experimental group by sternocleidomastoid the outside edge of the puncture catheter group, the control group by the anterior sternocleidomastoid cannulation group. Success rate were observed puncture the needle points to the distance of the internal jugular vein, a puncture catheter, time cannulation complete the time and related complications. The results of the first part (ultrasound imaging studies): the first partial 30 ° to the left, the right internal jugular vein and carotid artery overlap rate, cricoid horizontal plane, the seventh cervical horizontal surface of the horizontal plane and on the edge of the thyroid cartilage are statistically significant significance (P lt; 0.01), the inner diameter of the internal jugular vein in the cricoid horizontal plane the seventh cervical edge of the horizontal plane in the horizontal plane and the thyroid cartilage were statistically significant (P lt; 0.05), the lateral margin of the internal jugular vein to the sternoclavicular mastoid the muscle the outer edge of the lip horizontal distance in the the cricoid horizontal plane, the horizontal plane and the thyroid cartilage of the seventh cervical were statistically significant (P lt; 0.05). Head to the left partial 45 °, internal jugular vein and carotid artery overlap rate of the thyroid cartilage on the edge of the horizontal plane was significantly higher than the cricoid horizontal plane, the seventh cervical horizontal plane (P lt; 0.01), the inner diameter of the internal jugular vein in the cricoid horizontal plane, edge of the horizontal plane on the the seven cervical horizontal plane and the thyroid cartilage were statistically significant (P lt; 0.05), internal jugular vein sternocleidomastoid the outside edge distance outside edge to edge of the horizontal plane and the seventh cervical horizontal plane on the thyroid cartilage a significant difference (P lt; 0.05). In were not statistically significant (P gt; 0.05), internal jugular vein diameter in the head to the left the cricoid horizontal plane, carotid artery and jugular vein overlapping rate in the head, respectively, the left partial 0 °, 30 °, 45 ° partial 0 °, 30 °, 45 ° There were no statistically significant (P gt; 0.05), internal jugular vein distance of the outer edge of the sternocleidomastoid muscle to the outside edge of the skin in the head to the left side 30 °, 45 ° and head to the left side of 0 ° were statistically significant (P lt; 0.05). Were not statistically significant (P gt; 0.05), internal jugular vein diameter in the head in the seventh cervical horizontal plane, carotid artery and jugular vein overlapping rate in the head, left partial 0 °, 30 °, 45 ° to left deviation 0 °, 30 °, 45 ° There were no statistically significant (P gt; 0.05), head to the left side 30 °, 45 °, the lateral margin of the internal jugular vein to the sternocleidomastoid the outside edge of the skin distance and head to the left side 0 ° were statistically significant (P lt; 0.05). Part II (clinical research): the experimental group once cannulation success rate compared with control group with statistical significance (P lt; 0.05), the experimental group once cannulation completion time and the control group was statistically significant (P lt; 0.05), two sets of false perforating arteries, hematoma formation complication rates were statistically significant (P lt; 0.05). Skin puncture needle points to the distance of the internal jugular vein, and two groups was not statistically significant (P gt; 0.05). Conclusion by the outer edge of the right side of the neck of the sternocleidomastoid vein catheterization the ideal puncture postural and area head to the left side of 30 ° to 45 ° cricoid to the seventh cervical horizontal surface area; sternoclavicular mastoid the muscle lateral border of the right internal jugular vein catheterization is superior by sternocleidomastoid the triangle vertex Cannulax, can be used clinically.
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