2种途径深静脉穿刺中心静脉置管的Meta分析

Meta analysis of two approaches for central venous catheterization through deep vein puncture

目的比较颈内静脉（IJV）与锁骨下静脉（SV）穿刺中心静脉置管部分并发症发生率。方法收集有关IJV与SV穿刺中心静脉置管的临床对照研究，根据纳入标准纳入文献。对纳入文献进行Meta分析并对结果行敏感性分析。结果纳入18篇文献。Meta分析结果提示UV与SV穿刺中心静脉置管导管相关性感染率差异有统计学意义[RR=1．74，95％CI（1．32，2．30）1，误入动脉率差异有统计学意义[RR=3．19，95％CI（1．70，5．99）]，一次穿刺成功率差异无统计学意义[RR=1．06，95％CI（0.90，1．24）1。结论UV穿刺中心静脉置管导管相关性感染率及误入动脉率高于SV穿刺；尚不能认为2组一次穿刺成功率有差别；本结果仍需要高质量的随机对照试验来评价。

Objective The incidence rate of complication during central venous catheterization through internal jugular vein （IJV）and subclavian vein （SV）puncture. Methods Clinical controlled trials about IJV and SV puncture were collected and related literatures were screened according to the criteria of inclusion.The literatures underwent Meta analysis and subsequent analysis of sensitivity. Results A total of 18 literatures were included.Meta analysis indicated that statistical difference existed in the related infection rate[RR=1.74,95%CI（ 1.32,2.30）] and arterial puncture[RR=3.19,95%CI（ 1.70,5.99）] ,but not in the one-time-puncture success rate [RR=1.06,95%CI （0.90,1.24）] between IJV and SV puncture. Conclusions The rate of related infection and arterial puncture was higher by IJV than by SV puncture. But we could not confirm if any difference existed in the one-time-puncture success rate between the two methods.The results still needs evaluation by high--quality randomly controlled experiments.