Clinical observation on four different approaches of internal jugular vein puncture

Objective To guide the central venous puncture catheter by four different approaches of internal jugular vein puncture.Methods 2200 cases of open heart surgery through extracorporeal circulation which needed internal jugular vein puncture,were randomly divided into four groups(n=550): former road method in group A;mid-way method in group B;posterior method in group C;low clavicle incisura method in group D.The first puncture success rate,total puncture success rate,and the related complications were observed.Results The first puncture success rate and total puncture success rate in A,B,C groups were obviously higher than that in the D group(P 0.05),but the arterial hematoma incidence in A,B,C three groups were obviously higher than that in the D group(P 0.05).13 cases(2.4%) of hemopneumothorax was only observed in group D.Conclusion Only mastery learning the anatomy of internal jugular vein and various puncture ways can improve the success rate of puncture and reduce the related complications.