长期静脉治疗患者选什么部位置管最佳？-2007年考克兰系统评价

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Central venous access sites for the prevention of venous thrombosis, stenosis and infection in patients requiring longterm intravenous therapy (Review)
Hamilton HC, Foxcroft D
This is a reprint of a Cochrane review, prepared and maintained by The Cochrane Collaboration and published in The Cochrane Library 2008, Issue 2

[Intervention Review]
Central venous access sites for the prevention of venous thrombosis, stenosis and infection in patients requiring longterm
intravenous therapy
Helen C Hamilton1, David Foxcroft2
1c/o The Cochrane Anaesthesia Review Group, Rigshospitalet, Dep. 33-4-52, Copenhgen, Denmark. 2School of Health and Social Care, Oxford Brookes University, Oxford, UK
Contact address: Helen C Hamilton, c/o The Cochrane Anaesthesia Review Group, Rigshospitalet, Dep. 33-4-52, Blegdamsvej 9, ,Copenhgen, 2100, Denmark. helen.hamilton3@btopenworld.com.
Editorial group: Cochrane Anaesthesia Group.
Publication status and date: Edited (no change to conclusions), published in Issue 2, 2008.
Review content assessed as up-to-date: 16 April 2007.
Citation: Hamilton HC, Foxcroft D. Central venous access sites for the prevention of venous thrombosis, stenosis and infection in
patients requiring long-term intravenous therapy. Cochrane Database of Systematic Reviews 2007, Issue 3. Art. No.: CD004084. DOI:
10.1002/14651858.CD004084.pub2.
Copyright © 2008 The Cochrane Collaboration. Published by JohnWiley & Sons, Ltd.

A B S T R A C T
Background
Central venous access (CVA), in which a large bore catheter is routed through a vein in the neck, upper chest or femoral area, is needed to give drugs that cannot be given by mouth or via a conventional cannula in the arm.
Objectives
To establish whether either the jugular, subclavian or femoral CVA routes result in a lower incidence of venous thrombosis, venous stenosis or infection related to CVA devices.
To determine whether the circumference of a long-term central venous access device influences the incidence of venous thrombosis,venous stenosis or infection related to CVA devices.
Search strategy
We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2006, Issue 4), MEDLINE,
CINAHL, EMBASE (from inception to December 2006), reference lists of identified trials, and bibliographies of published reviews.
We also contacted researchers in the field. There were no language restrictions.
Selection criteria
We included randomized controlled trials comparing central venous catheter insertion routes.
Data collection and analysis
Two authors assessed potentially relevant studies.We resolved disagreements by discussion. Relevant outcomes were: venous thrombosis,venous stenosis, infection related to CVA devices, mechanical complications (e.g misplaced catheter, minor bleeding, haematoma).