Ultrasonographic Study Of Internal Jugular Vein In Patients With Mitral Valve Disease

Purpose The cross-sectional area of the internal jugular vein,the relationship between the ipsilateral carotid artery and the internal jugular vein in different head position and posterior mitral valve disease were observed by B-mode ultrasonography.Compared with those without heart disease,Intravenous puncture of the reasonable position and head position.Methods Thirty patients with mitral valve disease were randomly selected as the experimental group,the heart function Ⅱ～Ⅳ grade and the patients without heart disease as the control group.Both groups used the same measurement method,followed by supine position,Trendelenburg position(10° head low foot high,here:inafter referred to as the head low),anti-Trendelenburg position(10 ° head high foot low,hereinafter referred to as the first high),respectively Turn the patient’s head to the right by 0 °,30 °and 90 °,turn 0 °,30 ° and 90 ° to the left.Select the vertex of the sternocleidomastoid trigonometric triangle as the measurement point.The cross-sectional area of the internal jugular vein,the length of the internal jugular vein and the ipsilateral carotid artery overlap were measured in three different puncture positions and head deflection at different angles.Results 1.The cross-sectional area of the left and right jugular vein in the mitral valve group was larger than that in the ipsilateral jugular vein in the control group.2.Compared with the supine position,the cross-sectional area of the bilateral jugular vein in the control group was significantly decreased when the head is high(P<0.05),and the cross-sectional area of the jugular vein was significantly increased when the head is low(P<0.05).In the same position,compared with the head 0°,the head to the opposite side of 30°,90° can significantly increase the control group bilateral jugular vein cross-sectional area(P<0.05),there was no significant difference between the two groups when the head to the opposite side of 30° and 90°(P>0.05).Mitral valve group at the height of the head when the bilateral jugular vein cross-sectional area than the supine and head low when the head high,the head to the other side of the deflection of 30°can significantly increase the cross-sectional area of the internal jugular vein,there was no significant difference between 90°and 0°;In the supine position,the deflection of the head to the other side had no significant effect on the cross-sectional area of the internal jugular vein(P>0.05);When the head was low,head left partial 30°and 90° can significantly reduce the right jugular vein cross-sectional area(P<0.05),but there was no significant difference between 90° and 30°;There was no significant effect on the right lateral jugular vein cross-sectional area when the head is deflected to the right(P>0.05).3.In the same position,the distance between the two sides of the same side of the internal jugular vein and common carotid artery with the head to the contralateral deflection angle increases gradually decreased(P<0.05),that is,the carotid artery is covered by internal jugular vein The degree gradually increased.In the control group,the distance between the left and right internal jugular vein and ipsilateral carotid artery was significantly different between the three positions(P<0.05),the head height was the largest and the head was low Minimal.In the mitral valve group:(1)head deflection 0 °,head height when the left internal jugular vein and common carotid artery spacing was significantly lower than the supine and head low(P<0.05);head were right 30°,90(P>0.05).There was no significant difference in the distance between the left internal jugular vein and common carotid artery(P>0.05).(2)head deflection 0 °,the head of the right side of the right internal vein and common carotid artery spacing was significantly lower than the supine and head low(P<0.05);head left partial 30°,the first high position of the right internal vein and neck Arterial space was significantly lower than the supine and head low(P<0.05).Conclusion 1.The cross-sectional area of the left and right jugular vein in the patients with mitral valve disease was larger than that in the control group.2.Compared with supine position,the cross-sectional area of the bilateral jugular vein in the two groups was significantly reduced at the height of the head,and the cross-sectional area of the jugular vein was significantly increased.3.In the absence of heart disease patients with sternocleidomastoid muscle triangular vertices for internal jugular vein catheterization,Trendelenburg position(10°head low enough)is the ideal puncture position,while the head to the other side of the deflection is conducive to the internal jugular vein Filling,can increase the cross-sectional area of the internal jugular vein,but in order to reduce the risk of misuse of the artery,head deflection angle should not exceed 30°.4.When the mitral valve patients with sternocleidomastoid muscle triangular vertex for internal jugular vein catheterization,supine position or head low position and the head to the opposite side of the deflection of 30° is the ideal position and head position,if the patient can not tolerate supine and head low,It is also possible to take the head high while turning the head 30° to the opposite side.