Clinical Study Of Improved Surface Location By Ultrasound In Catheterization Of Right Internal Jugular Vein

Objective: In this study,an improved ultrasonic surface localization method for right jugular vein puncture and catheterization was proposed,and the clinical practicability of this improved method was confirmed by comparing the puncture effect of improved ultrasonic surface localization method and conventional ultrasonic surface localization method under right jugular vein puncture and catheterization.The changes of the position relationship between the internal jugular vein and the common carotid artery were compared when the ultrasonic probe was scanned in different directions.Methods: A total of 108 patients with elective operation requiring internal jugular vein catheterization in our hospital from September 2019 to December 2020 were randomly divided into conventional group and improved group.In the conventional group,ultrasound probe was transected at the apex of the sternocleidomastoid triangle and perpendicular to the skin for predetermined puncture position,while in the improved group,ultrasound probe was transected at the apex of the sternocleidomastoid triangle and perpendicular to the ground for predetermined puncture position.The success rate of the first puncture,the number of puncture attempts,the time of puncture and catheterization,the penetration ratio of the posterior wall of the internal jugular vein and the complications of the right internal jugular vein puncture and catheterization were recorded by two methods.At the same time,the ultrasound probe was used to scan the internal jugular vein of 108 patients in the direction perpendicular to the skin and perpendicular to the ground successively before the puncture,and the position relationship between the internal jugular vein and the common carotid artery and the safe puncture distance was observed and recorded.Result : The first puncture success rates in the improved and conventional groups were88% and 68%,respectively,and the difference was statistically significant(P<0.05),the number of puncture attempts in the improved group was less than that in the conventional group(P<0.01),the time of puncture and catheterization was less than that of conventional group(P<0.01),the penetration rate of posterior wall of internal jugular vein was lower than that of conventional group(P<0.05),the incidence of local hematoma was lower than that of conventional group(P<0.05),the differences were statistically significant.Use the probe perpendicular to the scanning direction and perpendicular to the direction of the skin surface,the position of the internal jugular vein and common carotid artery relations change,compared with the scanning probe perpendicular to the skin,scanning probe perpendicular to the ground when reducing the overlap distance of internal jugular vein and common carotid artery,safety puncture distance increases,the difference was statistically significant(P<0.05).Conclusion: The improved ultrasonic localization method compared with the conventional ultrasonic localization method is able to improve the success rate of first puncture,reducing puncture attempts,shorten the time,to reduce the internal jugular vein tube wall penetration ratio and reduce the incidence of local hematoma.Scanning the probe perpendicular to the ground can more accurately reflect the position relationship between the internal jugular vein and the common carotid artery and better guide the puncture and catheterization of the right internal jugular vein.