肥胖患者不同路径颈内静脉穿刺置管成功率比较(2)
试验中发现后路穿刺误入动脉的风险最高，但受限于样本数量偏小，尚未得出三组穿刺入路并发症发生率的统计学不同；同时，无论选择哪种穿刺入路，操作者的经验和规范的穿刺流程对成功的置管都是至关重要的；如果可以借助超声的帮助，将会更进一步地提高穿刺的成功率，减少并发症给患者带来的不适。
参考文献
[1] Renehan A G，Tyson M，Egger M，et al.Body-mass index and incidence of cancer：a systematic review and meta-analysis of prospective observational studies[J].The Lancet，2008，371(9612)：569-578.
[2] Harber C R，Harvey D J，Wiles M D，et al.The ability of anaesthetists to identify the position of the right internal jugular vein correctly using anatomical landmarks[J].Anaesthesia，2010，65(9)：885-888.
[3] Marcus H E，Bonkat E，Dagtekin O，et al.The impact of trendelenburg position and positive end-expiratory pressure on the internal jugular cross-sectional area[J].Anesth Analg，2010，111(2)：432-436.
[4] Fujiki M，Guta C G，Lemmens H J，et al.Is it more difficult to cannulate the right internal jugular vein in morbidly obese patients than in nonobese patients？[J].Obes Surg，2008，18(9)：1157-1159.
[5] Sigaut S，Skhiri A，Stany I，et al.Ultrasound guided internal jugular vein access in children and infant：a meta-analysis of published studies[J].Paediatr Anaesth，2009，19(12)：1199-1206.
(收稿日期：2014-11-04) (编辑：金燕), 百拇医药(陈芬兰 张伟 周东红)
参考文献
[1] Renehan A G，Tyson M，Egger M，et al.Body-mass index and incidence of cancer：a systematic review and meta-analysis of prospective observational studies[J].The Lancet，2008，371(9612)：569-578.
[2] Harber C R，Harvey D J，Wiles M D，et al.The ability of anaesthetists to identify the position of the right internal jugular vein correctly using anatomical landmarks[J].Anaesthesia，2010，65(9)：885-888.
[3] Marcus H E，Bonkat E，Dagtekin O，et al.The impact of trendelenburg position and positive end-expiratory pressure on the internal jugular cross-sectional area[J].Anesth Analg，2010，111(2)：432-436.
[4] Fujiki M，Guta C G，Lemmens H J，et al.Is it more difficult to cannulate the right internal jugular vein in morbidly obese patients than in nonobese patients？[J].Obes Surg，2008，18(9)：1157-1159.
[5] Sigaut S，Skhiri A，Stany I，et al.Ultrasound guided internal jugular vein access in children and infant：a meta-analysis of published studies[J].Paediatr Anaesth，2009，19(12)：1199-1206.
(收稿日期：2014-11-04) (编辑：金燕), 百拇医药(陈芬兰 张伟 周东红)