探讨超声引导联合腔内心电图定位技术在中心静脉置管中的应用价值。

回顾性分析我院2016年1月至2018年6月行超声引导下颈内静脉穿刺并经腔内心电图定位的52例中心静脉置管患者的临床资料，观察首次穿刺成功率、一次性置管到位率及置管并发症情况。

52例患者首次穿刺成功50例，首次穿刺成功率为96.2%，首次穿刺失败需2次穿刺并置管成功2例。所有患者穿刺过程未出现颈动脉误穿、血气胸、空气栓塞等并发症。52例患者经腔内心电图定位后行胸部X线检查，均证实导管头端位置理想，置管深度一次性到位率100%。2例患者在调整最佳置管深度过程中出现一过性心律失常，均得到及时纠正。

超声引导下颈内静脉穿刺可明确血管有无变异，准确引导穿刺，减少并发症，提高置管成功率。同时，腔内心电图可实时提示置管深度，便于及时、准确指导导管头端位置调整。

To explore the value of ultrasound guided combined intracavitary electrocardiography in central venous catheterization.

Retrospective analysis the clinical data of 52 patients underwent ultrasound guided central venous catheterization combined intracavitary electrocardiography location from January 2016 to June 2017. The first puncture success rate, catheter arrival rate and complications were observed.

A total of 50 cases were successfully punctured for the first time, and the first puncture success rate was 96.2%. And two cases needed two punctures for the first puncture failed. No complications such as carotid artery penetration, hemopneumothorax and air embolism occurred during the operation. All patients underwent chest X-ray examination to confirme that the catheter tip was in an ideal position. All the depth of catheterization reached the best postion at one time. Two patients had arrhythmia during operation and were treated promptly.

Ultrasound-guided internal jugular vein puncture can determine the presence or absence of vascular variability, accurately guide the puncture, reduce complications, and improve the success rate of catheterization. The intracavity electrocardiogram can prompt the catheter depth in real time, which helps to adjust the position of the catheter tip in time.