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中心静脉导管置管位点对导管相关性血栓及感染并发症的影响

2012-03-30 MedSci MedSci原创

中心静脉导管血栓感染
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　上海交通大学医学院附属新华医院急诊科与麻醉科合作的循证医学小组历时2年的研究“关于中心静脉导管置管位点对导管相关性血栓及感染并发症的影响”，其研究成果近日发表在国际上循证医学最权威组织Cochrane协作网出版的Cochrane系统评价资料数据库（Cochrane Database of Systematic Review，CDSR ，IF 6.18分）。该循证医学研究团队的这一成果是中国大陆急

　上海交通大学医学院附属新华医院急诊科与麻醉科合作的循证医学小组历时2年的研究“关于中心静脉导管置管位点对导管相关性血栓及感染并发症的影响”，其研究成果近日发表在国际上循证医学最权威组织Cochrane协作网出版的Cochrane系统评价资料数据库（Cochrane Database of Systematic Review，CDSR ，IF 6.18分）。该循证医学研究团队的这一成果是中国大陆急诊和重症监护领域第一篇以全文发表在该出版物的文章，研究旨在探索导管相关并发症的最新循证医学进展, 以期为新指南的制定提供证据，从而利于导管相关感染的临床规范化管理。

　　在日常医疗实践中, 尤其是在急诊抢救室及重症加强治疗病房, 中心静脉置管是不可或缺的处置手段，然而, 随之产生的导管相关并发症, 包括机械损伤、感染、血栓形成等也日益突出, 从而导致病人住院时间延长, 病死率的增加, 医疗负担进一步加重。 已有研究表明中心静脉置管位点的选择对减少导管相关性感染并发症具有重要意义。但目前导管相关指南对中心静脉穿刺位点选择并无明确推荐。该研究小组共查找了5854篇国内外关于导管相关并发症的研究，经过严格的纳入与排除标准审核，并根据最终纳入的随机对照试验分析表明：对需要长期中心静脉置管（>1月）的肿瘤患者，锁骨下静脉与颈内静脉具有相同的导管相关并发症风险，该证据推荐级别为中级；在短期中心静脉置管（<1月）中，锁骨下静脉置管因其显著减少感染与血栓并发症而优于股静脉置管，该证据推荐级别为高级；在血液净化置管中，颈内静脉置管并不优于股静脉置管，并且颈内静脉置管较股静脉置管存在更多的机械并发症风险，该证据推荐级别为中级。

　　Cochrane协作网是一个国际性组织，其目的是收集临床医学各专业和亚专业的全世界临床研究结果，进行系统评价/Meta分析，得出的结果为医疗实践及卫生决策提供科学可靠的依据。Cochrane系统综述(Cochrane systematic review，CSR）很重要的用户是各国政府的卫生决策机构。国际上许多发达国家的治疗指南均以CSR为依据

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    2013-03-08 fusion

    #静脉#

    0

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    2012-06-09 shenxlcyp

    #相关性#

    0

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    2012-06-25 guojianrong

    #中心静脉#

    0

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    2012-10-26 丁鹏鹏

    #并发#

    0

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    2012-04-01 lancelotzzl

    #中心静脉导管#

    0