超声引导下血管穿刺长短轴的选择:Meta分析
投稿时间:2017-12-17  修订日期:2017-12-20  点此下载全文
引用本文:吕炎基,余璞琳,刘淼,王桂月,李禹杭,王常松.超声引导下血管穿刺长短轴的选择:Meta分析[J].医学研究杂志,2018,47(10):45-48
DOI: 10.11969/j.issn.1673-548X.2018.10.013
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作者单位E-mail
吕炎基 150000 哈尔滨医科大学附属第一医院麻醉科  
余璞琳 150000 哈尔滨医科大学附属第一医院麻醉科  
刘淼 150040 哈尔滨医科大学附属肿瘤医院重症医学科  
王桂月 150040 哈尔滨医科大学附属肿瘤医院重症医学科  
李禹杭 150040 哈尔滨医科大学附属肿瘤医院重症医学科  
王常松 150040 哈尔滨医科大学附属肿瘤医院重症医学科 changsongwang@aliyun.com 
基金项目:国家自然科学基金资助项目(81402462)
中文摘要:目的 通过Meta分析比较通过长短轴途径的超声引导对血管穿刺的影响。方法 笔者分别检索了Cochrane Library、Embase、Medline、Cinahl和Web of Science 5个数据库,共收录7篇评估超声通过长短轴引导下进行血管穿刺的随机对照实验。主要的终点是第一次穿刺成功率,次要终点包括平均成功时间,平均穿刺成功次数。笔者通过随机效应模型计算了具有95%CI的二分结果的95%可信区间(CI)和相对风险(RR)的连续结果的加权平均差异(WMD)。结果 随机效应模型Meta分析结果显示,两组超声引导方式在穿刺成功率(RR=1.064,95% CI:0.924~1.225,P=0.387),穿刺成功时间(MD=1.761,95%CI:-7.087~10.609,P=0.696),平均成功尝试次数(MD=-0.021,95%CI:-0.282~0.240,P=0.876),差异无统计学意义。结论 对于行超声引导下血管穿刺的患者来说,选择长轴法或短轴法比较,差异无统计学意义。
中文关键词:超声  血管穿刺  长轴  短轴  荟萃分析
 
Evaluating the Long-axis and Short-axis Approaches for Ultrasound-guided Vascular Access Cannulation: A Systematic Review and Meta-analysis
Abstract:Objective To conducted a Meta-analysis of randomized controlled trials to compare the effects of long-axis(LAX) and short-axis(SAX) approaches of ultrasound-guidance for vascular access cannulation. Methods We searched five databases with Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, Embase, Medline, Cinahl and Web of Science. Seven randomised clinical trials assessing ultrasound-guidance for vascular access cannulation by the LAX or SAX approaches was included. The primary end point was the first-pass success rate. Secondary end points included mean time to success, average number of attempts to success. We calculated the weighted mean differences (WMDs) for continuous outcomes with 95% confidence intervals (CIs) and relative risks (RRs) for dichotomous outcomes with 95% CI by random-effects model. Results There were no significant differences between long axis technique and short axis technique for the first-pass success rate (RR=1.064, 95% CI:0.924-1.225, P=0.387),the mean time to success (MD=1.761, 95% CI:-7.087-10.609, P=0.696), and the mean attempts to success(MD=-0.021, 95% CI:-0.282-0.240, P=0.876). Conclusion There is no sufficient evidence to definitively choose either LAX or SAX in patients undergoing ultrasound-guided vascular access cannulation.
keywords:Ultrasound  Vascular access cannulation  Long-axis(LAX)  Short-axis(SAX)  Meta-analysis
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