摘要
目的系统评价无针接头对中心静脉置管患者相关并发症的影响。方法计算机检索PubMed、The Cochrane Library、Web of Science、Embase,中国生物医学文献数据库、中国知网、万方数据库中关于无针接头对中心静脉置管患者相关并发症的随机对照试验(RCT),检索时间均为建库至2018年3月。2名研究者严格按照纳入、排除标准独立筛选文献,提取资料,评价纳入研究的偏倚风险,应用Stata 12.0软件进行统计分析。结果最终纳入29个随机对照试验(RCT)4 052例患者,其中27篇文献比较无针接头和肝素帽相关并发症,2篇文献比较无针接头和三通接头相关并发症。Meta分析结果显示,使用无针接头的中心静脉置管患者CRBSI发生率(RR=0.25,95%CI:0.18~0.35)、堵管发生率(RR=0.17,95%CI:0.13~0.23)、回血发生率(RR=0.11,95%CI:0.08~0.15)、静脉炎发生率(RR=0.21,95%CI:0.11~0.41)、针刺伤发生率(RR=0.12,95%CI:0.03~0.43)及拔管发生率(RR=0.100,95%CI:0.038~0.259)均低于肝素帽/三通接头组,差异均有统计学意义(均P<0.01)。结论无针接头可以降低中心静脉置管患者相关并发症的发生率。
Objective To systematically evaluate the effect of needleless connectors on central venous catheterization(CVC)-related complications in patients. Methods Randomized controlled trials (RCT) on effect of needleless connectors on CVC-related complications in patients were retrieved from PubMed, The Cochrane Library, Web of Science, Embase, China Biomedical Literature Database, China National Knowledge Infrastructure(CNKI)and Wanfang Database, the retrieval time was from establishment of database to March 2018. Two researchers independently screened literatures according to inclusion and exclusion criteria, data were extracted, bias risk of included literatures were evaluated, Stata 12.0 software was used for statistical analysis. Results 29 RCTs,4 052 patients were included in the study, 27 literatures compared complications related to needleless collectors and heparin cap, and 2 literatures compared complications related to needleless connectors and tee connectors . Meta-analysis showed that the incidences of catheter-related blood stream infection (CRBSI)( RR , 0.25[95% CI , 0.18-0.35]), occlusion of catheter ( RR , 0.17[95% CI , 0.13-0.23]), return blood ( RR , 0.11[95% CI , 0.08-0.15]), phlebitis ( RR , 0.21[95% CI , 0.11-0.41]), needle stick injury ( RR , 0.12 [95% CI , 0.03-0.43]), and extubation ( RR , 0.100 [95% CI , 0.038-0.259]) in patients with needleless CVC were all lower than those in heparin cap/tee connector group, difference were all statistically significant (all P <0.01). Conclusion Needleless connector can reduce the incidence CVC-related complications in patients.
作者
刘慧莹
张志刚
马琳
杨彦
张彩云
田金徽
LIU Hui-ying;ZHANG Zhi-gang;MA Lin;YANG Yan;ZHANG Cai-yun;TIAN Jin-hui(School of Nursing, Lanzhou University, Lanzhou 730000, China;Department of Critical Care Medicine,The First Hospital of Lanzhou University, Lanzhou 730000, China;Department of Nursing, The First Hospital of Lanzhou University, Lanzhou 730000, China;Evidence -based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China)
出处
《中国感染控制杂志》
CAS
CSCD
北大核心
2019年第8期732-740,共9页
Chinese Journal of Infection Control
关键词
无针接头
感染
中心静脉置管
META分析
needleless connector
infection
central venous catheterization
Meta-analysis
