目的：利用彩色超声技术明确新生儿股静脉与股动脉间解剖关系及变异情况，以确定新生儿股静脉穿刺的安全部位，为盲探下股静脉穿刺置管的定位提供理论依据。方法随机选择2013年6月至12月行剖宫产术出生的新生儿30例，用超声探头于短轴方向垂直接触腹股沟韧带中点，并沿股血管走行向下移动探头，探测股静脉与股动脉的相对解剖位置，分别观察左、右共60对血管股静脉与股动脉排列关系及重叠率，腹股沟韧带下缘股静脉水平直径，股动脉、股静脉重叠起始处股静脉水平直径以及未覆盖股静脉体表投影长度。结果腹股沟韧带中点处股静脉在股动脉的内侧，呈平行排列，股静脉与股动脉紧贴并向内下方行走。在腹股沟韧带中点下缘（9.3±3.9）mm处动脉渐居静脉前方，变为前后排列。在腹股沟韧带中点下缘（20.8±5.3）mm（未覆盖股静脉体表投影长度）处股动脉完全覆盖股静脉，左右差异无显著性（P>0.05）。腹股沟韧带下缘股静脉水平直径（3.8±0.8）mm，股动脉、股静脉重叠起始段处股静脉水平直径（3.5±0.7）mm。结论在行新生儿股静脉穿刺时，应选择正确的位置，新生儿股静脉在腹股沟韧带中点至下方10mm左右，股静脉与股动脉处于内外排列关系，股静脉位于股动脉内侧3.8mm左右，该部位可能是股静脉穿刺的合适部位，在此部位穿刺，可减轻刺伤动脉的风险。%ObjectiveColor doppler ultrasound can reveal the anatomical differences between neonatal femoral artery and vein,and identify the safe neonatal femoral vein puncture site. The aim of the present study was to evaluate the value of using color doppler ultrasound to improve the success rate of neonatal femoral vein puncture and reduce the incidence of complications about femoral vein puncture.Methods30 cesarean birth neonates from May 2013 to December 2013 were selected randomly to receive ultrasound scan. Short Axis ultrasound guided approach was used and the transducer was perpendicular to the midpoint of the inguinal ligament. The anatomic relationship between the common femoral artery and vein were observed. The portion of femoral vein and artery overlap,femoral vein diameter,the initial segment of the femoral vein overlapping horizontal diameter and the length of the femoral vein not covered by the femoral artery were all recorded.ResultsThe femoral vein lied beside the femoral artery at the midpoint of inguinal ligament. At(9.3±3.9)mm from the middle point of inguinal ligament,the femoral artery lied in front of the femoral vein. At(20.8±5.3)mm from the middle point of inguinal ligament(not covering the surface projection of the femoral vein length),the femoral artery overlapped the femoral vein. There were no significant differences in the anatomical relationship of femoral vein and femoral artery between both sides. The diameters of the femoral vein under the inguinal ligament and at the initial segment were(3.8±0.8)mm and(3.5±0.7)mm,respectively. ConclusionsThe present study showed that the ideal site of neonatal femoral venipuncture is 1 cm below the inguinal ligament and 3.8mm medial to the femoral artery. It could help prevent injury to the femoral artery and avoid serious complications.
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