外周静脉留置针应用预充式导管冲洗器封管与肝素钠溶液封管效果的Meta分析

摘要

[目的]评价预充式导管冲洗器在外周静脉留置针封管中的应用效果。[方法]计算机检索中国生物医学数据库、中国知网、万方科技期刊全文数据库及维普期刊资源整合服务平台,收集关于外周静脉留置针应用预充式导管冲洗器封管与肝素钠溶液封管效果比较的随机对照试验,对纳入研究进行数据提取及质量评价后,采用 RevMan 5.2软件对数据进行 Meta分析。[结果]共纳入13项研究,合计1773例病人。Meta分析显示：两组堵管发生率比较差异有统计学意义[OR=0.50,95%CI(0.34,0.74),P=0.0004]；两组留置针回血发生率、局部外渗发生率比较差异无统计学意义(P=0.33,P=0.44)；两组静脉炎发生率差异有统计学意义[OR=0.36,95%CI(0.21,0.64),P=0.0005]；两组留置针平均留置时间差异有统计学意义[SMD=0.90,95%CI(0.09,1.72),P=0.03]；两组留置针封管操作时间差异有统计学意义[SMD=-11.86,95%CI(-13.08,-10.63),P<0.00001]。[结论]留置外周静脉留置针时应用预充式导管冲洗器封管,在降低堵管率、静脉炎发生率和延长留置针留置时间及缩短护士封管操作时间方面优于应用肝素钠溶液封管,在降低回血率、外渗率方面,两者优劣相当。%Objective:To evaluate the effectiveness of sealing peripheral venous catheter with pre filled catheter irrigator.Methods:By searching CBMdisc,CNKI,Wanfang and VIP database to collect randomized controlled trials (RCTs)of sealing peripheral venous catheter with pre filled catheter irrigator vs.Heparinsodium.After data extraction and quality assessment of included studies,a meta analysis was conducted by using RevMan 5.2 software.Results:Thirteen studies involving 1 773 patients were included in this study.The meta analysis showed that:there were significant differences between pre filled catheter irrigator sealing and heparin sodium sealing in peripheral venous catheter blockage[OR=0.50,95%CI(0.34,0.74),P=0.000 4].In terms of the in-dwelling needle blood return rate and incidence of phlebitis,there were no significant differences between the two groups[OR=0.36,95%CI(0.21,0.64),P=0.000 5].In terms of the average remaining time of peripheral venous catheter[SMD=0.90,95%CI(0.09,1.72),P=0.03]and the time needed for sealing peripheral venous catheter[SMD=-11.86,95%CI(-13.08,-10.63),P<0.000 1],there were significant differences between the two groups.Conclusions:Compared with heparin sodium sealing,pre filled catheter irrigator sealing meth-od can reduce the incidence of peripheral venous catheter blockage and phlebitis,prolong the remaining time of peripheral venous catheter and save time for nurses in operation of peripheral venous catheter sealing.While there were no significant differences in incidences of blood return and local leakage.