Application of Bedside Ultrasound-Guided Central Vein Puncture in the Perioperative Critically Patients with Tuberculosis

Objective: To observe the safety and value of bedside ultrasound-guided deep vein puncture in selecting the site of critical tuberculosis patients. Methods: From Aug 2023 to Oct 2024, 150 cases of ultrasound-guided deep vein puncture in Xi’an Chest hospital were selected, and 2 cases of cervical lymphadenopathy were excluded. Inclusion criteria: pre-anaesthesia assessment of the need for blood transfusion and surgical trauma in patients with excessive blood loss, hemorrhagic shock. Exclusion criteria: Patients with infection at the puncture site and bleeding tendency that is difficult to correct. According to the operation site, it was divided into internal jugular vein group, subclavian group and axillary vein group. According to standard practice for emergency ultrasound. The blood vessel was punctured by the short-axis positioning method, and the arteriovenous was marked by ultrasonic spectrum. During puncture, the needle insertion point was observed and the translational probe was used to find the needle tip. The ultrasound image needle tip was completely extracted into the venous vessel and inserted into the guide wire, and the guide wire was inserted into the vein. The first puncture success rate, total success rate, complications and postoperative comfort of the three groups were compared. Results: There was no significant difference in age, sex and body mass index among the three groups. Ultrasound-guided puncture of deep vein was successful in all three groups, the success rate of one puncture in the axillary vein group, the internal jugular vein group and the subclavian bone group were 95.8%, 93.8% and 84.3%, respectively. The success rate of one puncture in the axillary vein group was higher in the three groups, and the difference between the groups was statistically significant (P < 0.05). The first puncture was completed in the internal jugular vein group, and the difference was statistically significant (P < 0.05). The patient satisfaction in subclavian group was higher than that in axillary vein group, and the internal jugular vein was the lowest, and the catheter in axillary vein group was blocked. Conclusion: Bedside ultrasound-guided deep vein puncture improves the efficiency and safety, and the puncture time of internal jugular vein group is short, which is beneficial to the perioperative treatment of critical tuberculosis patients. When internal jugular vein cannot be punctured, axillary vein can be used instead.