中心静脉导管头端最佳位置影像学标识的系统评价

摘要

目的：对国内外探讨中心静脉导管头端最佳位置影像学标识的研究进行系统评价，分析并评鉴文献中报道的中心静脉导管头端最佳位置影像学标识的实施内容、可行性及其效果。方法运用循证护理的方法学，制订PECOD原则，检索Cochrane图书馆、JBI循证卫生保健国际合作中心图书馆、EM base、Elsevier、Web of know ledge、Ovid、CBM、CNKI和万方数据库中关于中心静脉导管头端最佳位置影像学标识的队列研究、病例对照研究及描述性研究。结果共纳入描述性研究文献4篇，对纳入研究进行描述性分析，气管隆凸下4 cm或2个胸椎椎体单元是较理想的影像学判断标识。结论目前X线胸片仍是确定中心静脉导管头端位置的首要方法，其影像学判断标识显得尤为重要。%Objective To evaluate the domestic and overseas studies exploring the imaging marks used to position the central venous catheters (CVCs) tip location ,and to analyze and assess the reported implementation ,feasibility and effect of the imaging identifications of catheter tips .Method Evidence‐based nursing methodology was used to establish PICOD prin‐ciple .Cohort study ,case‐control study and descriptive study about imaging marks of CVCs tip location were searched in Cochrane Library ,JBI Library ,EMbase ,Elsevier ,Web of Knowledge ,Ovid ,CBM ,CNKI and Wanfang Data .Quality of studies was evaluated and data were extracted by two researchers .Result Four descriptive studies were included .Descriptive analysis was conducted .The most reliable estimate of CVCs tip location was a point of 4cm or two vertebral body units be‐low the carina .Conclusion At present ,chest X‐ray is still the first choice used to identify the tip location of CVCs .And the imaging marks of catheter tips are particularly important .