Schug C B, Culhane D E, Knopp R K
Ann Emerg Med. 1986 Jul;15(7):769-73. doi: 10.1016/s0196-0644(86)80370-5.
Guidewire catheters have been used with increasing frequency during the last several years for placement of central venous lines. No data exist comparing success and complication rates of guidewire and nonguidewire catheterization in the emergency setting. A prospective, randomized study was conducted to compare GW and NGW central venous catheterization (CVC) by the infraclavicular subclavian approach. The study consisted of 210 patients (87 trauma, 123 medical) requiring a CVC as part of their emergency department care. Catheter placement and complications were determined by immediate chest radiograph, two-day followup, and chart review after discharge. Results demonstrated no statistically significant differences in success rates or complications, with the exception of catheter malfunction due to extrathoracic vascular placement or catheter kinkage. This complication occurred more frequently when the guidewire technique was used. The guidewire CVC technique does not appear to offer any improvement of complication rates when compared to the nonguidewire technique.
在过去几年中，导丝导管用于放置中心静脉导管的频率越来越高。在急诊环境中，尚无数据比较导丝导管插入术和非导丝导管插入术的成功率及并发症发生率。进行了一项前瞻性随机研究，以比较经锁骨下途径进行导丝（GW）和非导丝（NGW）中心静脉置管（CVC）的情况。该研究纳入了210例需要进行CVC作为急诊科治疗一部分的患者（87例创伤患者，123例内科患者）。通过即刻胸部X线片、两天随访及出院后病历审查来确定导管置入情况和并发症。结果显示，除了因胸外血管置管或导管扭结导致的导管故障外，成功率和并发症方面无统计学显著差异。使用导丝技术时，这种并发症更常发生。与非导丝技术相比，导丝CVC技术似乎并未降低并发症发生率。
