超声引导下血管穿刺长短轴的选择:Meta分析  

Evaluating the Long-axis and Short-axis Approaches for Ultrasound-guided Vascular Access Cannulation: A Systematic Review and Meta-analysis

作　　者：吕炎基 余璞琳 刘淼 王桂月 李禹杭 王常松[2] Lv Yanji;Yu Pulin;Liu Miao(Department of Anesthesiology,The First Affiliated Hospital of Harbin Medical University,Heilongjiang 150000,China)

机构地区：[1]哈尔滨医科大学附属第一医院麻醉科,150000 [2]哈尔滨医科大学附属肿瘤医院重症医学科,150040

出　　处：《医学研究杂志》2018年第10期45-48,共4页Journal of Medical Research

基　　金：国家自然科学基金资助项目(81402462)

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。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.

关 键 词：超声 血管穿刺 长轴 短轴 荟萃分析 

分 类 号：R4[医药卫生—临床医学]