在心脏手术期间确定的大左内静脉:一个病例报告
Kadİrİye S Elden1, Helİn Ozler1, Hasan Hepaguslar1
1Department of Anesthesiology and Reanimation, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey.
Saudi journal of anaesthesia
|September 25, 2025
概括
超声导向的中央静脉导管 (CVC) 揭示了心脏手术患者左侧内静脉 (IJV) 的扩大. 评估两个IJV对于安全的CVC安置至关重要,特别是当正确的IJV不足于最佳时.
科学领域:
- 心脏病学 心脏病学
- 血管外科 血管外科
- 麻醉学 麻醉学
背景情况:
- 中心静脉导管 (CVC) 是心脏外科手术中常见的一种手术.
- 由于解剖学的考虑,右侧内静脉 (IJV) 通常是CVC的首选位置.
- 患者的并发症和解剖学变异可能会影响CVC部位的选择.
研究的目的:
- 报告在超声波导向心血管控制过程中发现的左侧内关节显著扩大的病例.
- 为了突出评估两种IJV的重要性,以获得最佳的CVC地点选择.
- 强调基于实时超声波发现的CVC策略的调整.
主要方法:
- 超声波 (US) 指导用于中央静脉导管 (CVC).
- 进行了双边内静脉 (IJV) 和大脑动脉 (CA) 的解剖评估.
- 选择左侧静脉带导管是因为右侧静脉带的特点 (直径小,CA重叠高).
主要成果:
- 在手术前的超声波评估中,观察到左侧IJV的显著扩大.
- 右关节表现出一个小的前后直径,有显著的动脉重叠.
- 左侧静脉管导管治疗成功进行,没有任何并发症,这使得心脏手术更容易进行.
结论:
- 对两个内静脉的超声波评估对于安全有效的中央静脉通道至关重要.
- 在右侧IJV受损的情况下 (尺寸小,大动脉重叠),左侧IJV可以是一个合适的替代方案.
- 在心脏手术过程中,手术前的双边IJV评估优化了心脏复合部位的选择和患者在心脏手术中的安全性.
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