目的:观察超声引导对疑难危重患者行颈内静脉置管的效果。方法:选择需行颈内静脉穿刺留置导管的疑难危重患者60例,随机分为观察组和对照组各30例。观察组在超声引导下行颈内静脉穿刺置管,对照组凭体表解剖标志行颈内静脉穿刺置管。比较两组穿刺成功时间、穿刺次数、成功率、误伤动脉或胸膜、动静脉瘘、穿刺部位血肿、多次置管失败等并发症发生情况。结果:观察组穿刺成功时间(7±2)min,显著短于对照组的(16±10)min(P<0.05);一次穿刺成功率93.3%,非常显著高于对照组的30.0%(P<0.01)。观察组并发症发生率非常显著低于对照组(P<0.01)。结论:超声引导在疑难危重患者行颈内静脉置管的效果优于传统方法,穿刺时间短、一次穿刺成功率高、并发症少。 Objective: To observe the effect of ultrasound guided catheterization of internal jugular vein in patients with critical and critical diseases. Methods: Sixty cases of critical and critical patients requiring catheterization of internal jugular vein were randomly divided into observation group (30 cases) and control group (30 cases). The observation group underwent ultrasound-guided jugular vein catheterization, while the control group underwent catheterization of jugular vein with anatomic landmarks. The success rate of puncture, the number of puncture, the success rate, the accidental injury of arteries or pleura, arteriovenous fistula, puncture site hematoma and multiple catheter failure were compared between the two groups. Results: The successful time of puncture in observation group was significantly shorter than that in control group (7 ± 2) min (P <0.05). The success rate of primary puncture was 93.3%, which was significantly higher than that in control group (P <0.01). The incidence of complications in observation group was significantly lower than that in control group (P <0.01). Conclusion: Ultrasound-guided catheterization in patients with critical and dangerous internal jugular vein catheter is superior to the traditional method, puncture time is short, a puncture success rate, fewer complications.