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短轴与长轴超声引导下颈内静脉穿刺方法的比较：一项荟萃分析

Comparison of short and long axis ultrasound-guided approaches to internal jugular vein puncture: a meta-analysis.

作者信息

Zhang Jian, Wang Xiaohan, Miao Shuai, Shi Mengzhu, Wang Guanglei, Tu Qing

机构信息

Department of Anaesthesiology, The Third People's Hospital of Chengdu, Chengdu, Sichuan, China.

Department of Anaesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu, China.

出版信息

J Int Med Res. 2019 Sep;47(9):4069-4082. doi: 10.1177/0300060519867806. Epub 2019 Aug 20.

DOI:10.1177/0300060519867806
PMID:31429352
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6753526/
Abstract

OBJECTIVE

To compare short-axis versus long-axis plane for ultrasound-guided internal jugular vein puncture.

METHODS

PubMed, Embase, Cochrane Library and CNKI databases were searched for randomized controlled trials, published to 1 June 2019, that compared short- versus long-axis plane in ultrasound-guided internal jugular vein puncture. Statistical analyses were performed using RevMan software, version 5.3. Statistical results are presented as risk ratio (RR) (95% confidence interval [CI]) for dichotomous data and standard mean difference (SMD) (95% CI) for continuous data.

RESULTS

Ten studies fulfilled the inclusion criteria. Analyses of pooled results showed no statistically significant differences in arterial puncture incidence between the two planes (RR 0.73 [95% CI 0.38, 1.39]). First-pass success rate (RR 1.08 [95% CI 0.95, 1.22]), total success rate (RR 1.00 [95% CI 0.99, 1.02]) and number of attempts required (SMD –0.09 [95% CI –0.37, 0.18]) were also similar between the two approaches. Trial sequential analysis indicated that the available evidence was insufficient to detect potential differences between the two techniques.

CONCLUSIONS

There is insufficient data for an evidence-based choice of either short- or long-axis plane in ultrasound-guided internal jugular vein puncture.

摘要

目的

比较超声引导下颈内静脉穿刺的短轴平面与长轴平面。

方法

检索PubMed、Embase、Cochrane图书馆和中国知网数据库，查找截至2019年6月1日发表的比较超声引导下颈内静脉穿刺短轴平面与长轴平面的随机对照试验。使用RevMan 5.3软件进行统计分析。二分类数据的统计结果以风险比（RR）（95%置信区间[CI]）表示，连续数据的统计结果以标准化均数差（SMD）（95%CI）表示。

结果

10项研究符合纳入标准。汇总结果分析显示，两个平面之间的动脉穿刺发生率无统计学显著差异（RR 0.73[95%CI 0.38，1.39]）。两种方法的首次穿刺成功率（RR 1.08[95%CI 0.95，1.22]）、总成功率（RR 1.00[95%CI 0.99，1.02]）和所需穿刺次数（SMD –0.09[95%CI –0.37，0.18]）也相似。试验序贯分析表明，现有证据不足以检测两种技术之间的潜在差异。

结论

在超声引导下颈内静脉穿刺中，没有足够的数据支持基于证据选择短轴平面或长轴平面。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3fdc/6753526/94caf9a901cc/10.1177_0300060519867806-fig10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3fdc/6753526/6a4538bab636/10.1177_0300060519867806-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3fdc/6753526/a79be2da0633/10.1177_0300060519867806-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3fdc/6753526/2089dae03180/10.1177_0300060519867806-fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3fdc/6753526/1ea47c1362d6/10.1177_0300060519867806-fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3fdc/6753526/7899ca9b7900/10.1177_0300060519867806-fig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3fdc/6753526/6033ab365eed/10.1177_0300060519867806-fig6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3fdc/6753526/908209bb8962/10.1177_0300060519867806-fig7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3fdc/6753526/d4307d78b95f/10.1177_0300060519867806-fig8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3fdc/6753526/629463916ec6/10.1177_0300060519867806-fig9.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3fdc/6753526/94caf9a901cc/10.1177_0300060519867806-fig10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3fdc/6753526/6a4538bab636/10.1177_0300060519867806-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3fdc/6753526/a79be2da0633/10.1177_0300060519867806-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3fdc/6753526/2089dae03180/10.1177_0300060519867806-fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3fdc/6753526/1ea47c1362d6/10.1177_0300060519867806-fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3fdc/6753526/7899ca9b7900/10.1177_0300060519867806-fig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3fdc/6753526/6033ab365eed/10.1177_0300060519867806-fig6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3fdc/6753526/908209bb8962/10.1177_0300060519867806-fig7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3fdc/6753526/d4307d78b95f/10.1177_0300060519867806-fig8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3fdc/6753526/629463916ec6/10.1177_0300060519867806-fig9.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3fdc/6753526/94caf9a901cc/10.1177_0300060519867806-fig10.jpg

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