The clinical application of ultrasound in right internal jugular vein catheterization during hemodialysis

Objective Summarizing the experience of right internal jugular vein catheterization,to investigate the clinical application of ultrasound in right internal jugular vein catheterization during hemodialysis.Method Clinical data of 535 hemodialysis patients receiving right internal jugular vein catheterization were retrospectively analyzed,three methods were used in the catheterization including blind catheterization,ultrasonic positioning and ultrasonic guidance.Success rate,puncture time,patient satisfaction and the types and case numbers of complications were counted as well.Results There were 218 cases of routine blind catheterization,among them,103 cases were one-time success(47.25%),puncture time was 65±11 seconds,rate of success was 83.01%(181cases),local haematoma or emphysema occurred in 17cases(7.80%),carotid arterial mis-placement in 9cases(4.29%),nerve injury in 3 cases(1.38%),blood chest pneumothorax 1 cases(0.46%),patient satisfaction was 54.13%;Ultrasound-localized catheterization was conduct in 210 patients,121cases were one-time success(57.62%),puncture time was 45±8 seconds,rate of success was 91.43%(192 cases),local emphysema or hematoma in12 cases(5.71%),carotid arterial mis-placement in 4 cases(1.90%),and nerve damage 1 cases(0.48%),and with no blood chest and pneumothorax,patient satisfaction was 77.62%;107 cases were guided by ultrasound,92 cases were one-time success(85.98%),puncture time 30±7 seconds and rate of success was 100%,except emphysema occurred in 1 case,no complications occurred,patient satisfaction was 82.22%.Compared with routine blind catheterization,ultrasonic positioning,especially guided by ultrasound has great advantage.Conclusion Right internal jugular vein catheterization is a high-risk traumatic procedure.Correct methods and ultrasound assistance can effectively shorten operating time,reduce complications,improve success rate and patient satisfaction.