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为对动脉搏动和解剖标志指导穿刺颈内静脉的两种方法进行比较，对５９８例患者颈内静脉穿刺的结果及并发症进行分析。前２１３例采用动脉搏动指导穿刺法，后３８５例采用解剖标志指导穿刺法。结果表明：解剖标志指导穿刺法的总穿刺和一次穿刺成功率均显著高于动脉搏动指导穿刺法（９９．２％ｖｓ９５．７％、８３．８％ｖｓ７３．７％，Ｐ＜０．０５和＜０．０１），而平均穿刺次数和时间前者明显少于后者（１．２±０．５次ｖｓ２．７±２．９次、１．９±５．３ｍｉｎｖｓ３．１±４．７ｍｉｎ，Ｐ均＜０．０５）；两种穿刺方法的并发症发生率分别为３．４％和１１．７％（Ｐ＜０．０１），主要并发症为误穿颈总动脉（８．０％ｖｓ２．１％，Ｐ＜０．０１），２例血胸均发生于动脉搏动指导穿刺法。提示解剖标志指导穿刺法可提高穿刺成功率和减少并发症的发生。
To compare the two methods of arterial pulsation and anatomical landmarks that guide the puncture of the internal jugular vein, the results and complications of jugular vein puncture in 598 patients were analyzed. The first 213 cases of arterial pulsation guided puncture method, the latter 385 cases using anatomical landmarks puncture method. The results showed that the total puncturing and puncturing success rates were significantly higher than those of arterial pulsation guided puncture (99.2% vs 95.7%, 83.8% vs 73.7%, P <0.05 and <0.01), while the mean number of punctures and time was significantly less than the latter (1.2 ± 0.5 vs2.7 ± 2.9, 1.9 ± 5.3min vs3 ± 4.7min, P <0.05). The complication rates of the two methods were 3.4% and 11.7% (P <0.01) vs2.1%, P <0.01), 2 cases of hemothorax occurred in arterial pulsation guided puncture. Tip of anatomical landmarks to guide the puncture method can improve the puncture success rate and reduce the incidence of complications.