探讨颈外静脉留置针穿刺在急性创伤性休克患者急诊科抢救中建立静脉通道和静脉采血中的优势。

选取2015年1月至2016年10月于火箭军总医院急诊科因急性创伤性休克需建立静脉通道的203例患者，按照随机数字表法分为实验组(颈外静脉穿刺采血后建立静脉通道组)102例，对照组(外周静脉穿刺采血后建立静脉通道组)101例，分别统计两组患者静脉穿刺的成功率；静脉穿刺采血并建立静脉通道的成功率；2 min内静脉穿刺的成功率以及成功建立静脉通道的穿刺次数，计数资料采用χ²检验，计量资料采用t检验。

实验组静脉穿刺的成功率为99.1%，对照组为92.8%，两组比较差异有统计学意义(χ²＝4.81，P<0.05)；实验组静脉穿刺采血并建立静脉通道的成功率为98.04%，对照组为82.18%，两组比较差异有统计学意义(χ²＝14.37，P<0.05)；实验组2 min内静脉穿刺的成功率为91.18%，对照组为70.30%，两组比较差异有统计学意义(χ²＝14.25，P<0.05)；实验组建立静脉通道的穿刺次数为(1.13±0.40) 次，对照组为(1.41±0.93) 次，两组比较差异有统计学意义(t＝3.28，P<0.05)。

颈外静脉穿刺在急性创伤性休克患者急诊抢救过程中可提高静脉穿刺采血后建立静脉通道的成功率。

To explore the advantages of external jugular vein needle puncture in the treatment of intravenous access and intravenous blood extraction of patients with acute traumatic shock.

A total of 203 patients with acute traumatic shock were selected from January 2015 to October 2016 in the Department of Emergency, the Chinese People′s Liberation Army Rocket Forces General Hospital. The patients were divided into experimental group (n=102) and control group (n=101) according to random number method. Jugular accesses of patients in the experimental group were established by extracting blood with external jugular vein puncture. Jugular accesses of patients in the control group were established by extracting blood with peripheral jugular vein puncture. The success rate of vein puncture, vein puncture blood and establishing venous access, vein puncture in 2 minutes were recorded respectively. The number of punctures to establish the venous access successfully were recorded, too. The counting data were processed with χ² test, and the measurement data were processed with t test.

The success rate of vein puncture was 99.1% in the experimental group and 92.8% in the control group, and there was significant difference between the two groups(χ²=4.81, P< 0.05). The success rate of vein puncture blood and establishing venous access in the experimental group was 98.04% while the control group was 82.18%, and there was significant difference between the two groups(χ²=14.37, P<0.05). The success rate of vein puncture was 91.18% in the experimental group and 70.30% in the control group, there was significant difference between the two groups (χ²=14.25, P<0.05). The number of punctures in the experimental group was (1.13±0.40) times and it was (1.41±0.93) times in the control group, and there was significant difference between the two groups (t= 3.28, P<0.05).

The external jugular vein puncture in emergency resuscitation of patients with acute traumatic shock can improve the success rate of vein puncture blood and establishing venous access.