关键词: 中心静脉, 解剖定位, 穿刺置管, 肝移植

Abstract:

Objective　To compare the success rate and incidence of complications of central venous catheterization via internal jugular vein (IJV) versus subclavian vein (SCV) using anatomic landmarks, and to give suggestion for easy and safe choosing in clinic.　Methods　A randomized, crossover study in patients undergoing semi-selective liver transplantation were performed. After anesthesia induction, the IJV and SCV were punctured and catheterized using anatomic landmarks consecutively in a randomized crossover fashion by the same anesthesiologists. The data collected included the number of venipuncture and guidewire insertion attempts until success, the time from first venipuncture to successful guidewire insertion, and the associated complications.　Results　Cannulation via SCV required more attempts than via IJV (2.9±1.4 vs 2.3±0.7, n=42, P<0.05), however, cannualtion via SCV was more time comsuming than via IJV (2.24±1.01 vs 1.58±0.49 min, n=42, P<0.05). One patient developed a hematoma after accidental carotid artery puncture during the process of IJV catheterization. Arterial puncture did not occur during SCV catheterization, but a hematoma developed in one patient.　Conclusions　Central venous cannulation via IJV is more easier and quicker than via SCV.

Key words: Central vein;　anatomic landmarks;　Cannulation;　Liver transplantation