摘要
目的探讨导管预处理对预防PICC静脉炎的效果,应用网状Meta分析得出预防PICC静脉炎最优的导管预处理溶液。方法计算机检索PubMed、Web of Science、EMBASE、Cochrane Library、EBSCO、中国知网、维普数据库和万方数据期刊论文资源数据库,运用Stata14.0软件进行分析。结果共纳入16篇随机对照试验,包含3998例患者,涉及12种导管预处理溶液。森林图显示导管预处理溶液中常规生理盐水与0.125 mg/ml地塞米松溶液、50 U/ml肝素钠+0.25 mg/ml地塞米松混合液、0.08 mg/ml地塞米松溶液、50 U/ml肝素钠溶液、0.05 mg/ml地塞米松溶液、1.67 mg/ml地塞米松溶液差异有统计学意义(P<0.05)。不同溶液之间,0.04 mg/ml地塞米松溶液与0.125 mg/ml地塞米松溶液、0.08 mg/ml地塞米松溶液、0.05 mg/ml地塞米松溶液、1.67 mg/ml地塞米松溶液差异有统计学意义(P<0.05)。累积排序概率曲线下面积图(surface under the cumulative ranking,SUCRA)结果显示以下前4种导管预处理溶液预防PICC静脉效果较好,依次是1600 U/ml庆大霉素+0.125 mg/ml地塞米松溶液、50 U/ml肝素钠+0.25 mg/ml地塞米松混合液、0.05 mg/ml地塞米松溶液和50 U/ml肝素钠溶液。结论基于网状Meta分析结果与累积排序概率曲线下面积排序结果,导管预处理溶液与静脉炎的发生密切相关,1600 U/ml庆大霉素+0.125 mg/ml地塞米松溶液、50 U/ml肝素钠+0.25 mg/ml地塞米松混合液、0.05 mg/ml地塞米松溶液和50 U/ml肝素钠溶液预防静脉炎效果优于其他预处理溶液,但仍需大样本研究进一步证实。
Objective To explore the effect of catheter pretreatment on the prevention of PICC phlebitis,the best solution of catheter pretreatment was obtained by network Meta-analysis.Methods The databases of PubMed,Web of Science,EMBASE,Cochrane Library,EBSCO,CNKI,VIP,and Wanfang were searched by computer and analyzed by Stata14.0 software.Results A total of 16 randomized controlled trials,including 3998 patients,involved 12 catheter pretreatment solutions.The forest map showed that the difference between normal saline and 0.125 mg/ml dexamethasone solution,50 U/ml heparin sodium+0.25 mg/ml dexamethasone mixture,0.08 mg/ml dexamethasone solution,50 U/ml heparin sodium solution,0.05 mg/ml dexamethasone solution and 1.67 mg/ml dexamethasone solution was statistically significant(P<0.05).There was statistically significant difference between 0.04 mg/ml dexamethasone solution and 0.125 mg/ml dexamethasone solution,0.08 mg/ml dexamethasone solution,0.05 mg/ml dexamethasone solution and 1.67 mg/ml dexamethasone solution(P<0.05).The results of area plot under cumulative sorting probability curve showed that the following four kinds of catheter pretreatment solutions had better effect on preventing PICC phlebitis:1600 U/ml gentamicin+0.125 mg/ml dexamethasone solution,50 U/ml heparin sodium+0.25 mg/ml dexamethasone mixture,0.05 mg/ml dexamethasone solution and 50 U/ml heparin sodium solution.Conclusions Based on the results of network Meta-analysis and the results of Sucra sequencing,the catheter pretreatment solution is closely related to the occurrence of phlebitis,1600 U/ml gentamicin+0.125 mg/ml dexamethasone solution,50 U/ml heparin sodium+0.25 mg/ml dexamethasone mixture,0.05 mg/ml dexamethasone solution and 50 U/ml hepatic sodium solution are better than other pretreatment solutions in the prevention of phlebitis,but large samples are still needed to verify.
作者
崔钰
惠静
何月
董丽
Cui Yu;Hui Jing;He Yue;Dong Li(Department of Nursing,the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300000,China)
出处
《中华现代护理杂志》
2019年第32期4175-4180,共6页
Chinese Journal of Modern Nursing
关键词
PICC
静脉炎
预处理
网状Meta分析
Peripherally inserted central catheter
Phlebitis
Pretreatment
Network Meta-analysis
