肝素稀释液维持新生儿PICC导管通畅作用的meta分析  

The efficacy of heparin in maintaining the patency of peripherally inserted central catheters in neonates:a meta-analysis

作　　者：彭易[1] 程云[2] 芦婳[1] 吉洁[1] 白姣姣[3] 夏文兰[4] 

机构地区：[1]复旦大学护理学院,上海市200040 [2]复旦大学附属华东医院护理部 [3]复旦大学附属华东医院消化内科 [4]复旦大学附属华东医院ICU

出　　处：《中华护理杂志》2012年第11期1023-1027,共5页Chinese Journal of Nursing

基　　金：复旦大学护理科研基金资助项目(编号:FNF201012)

摘　　要：目的评价使用肝素稀释液维持新生儿PICC导管通畅的效果。方法计算机检索JBI循证卫生保健国际合作中心图书馆,Medline(1966年1月至2011年6月),EMbase(1989年1月至2011年6月),CINAHL(Cumulative Index to Nursing and AlliedHealth Literature)(1982年1月至2011年6月),CBMdisc(1978年1月至2011年6月),中国学术期刊网络出版总库(1994年1月至2011年6月),Cochrane图书馆(2011年第2期)等中符合纳入及排除标准的中、英文公开发表的临床随机对照试验,由3名研究者对文献质量进行严格质量评价、提取,对符合质量标准的研究使用RevMan 5.0软件对结局指标进行分析和描述。结果共纳入6项临床随机对照试验,meta分析结果显示,伴随肠外营养液的输注,或单独持续滴注肝素稀释液,对预防新生儿输注过程中PICC的堵管有显著效果,在肠外营养液中添加肝素稀释液持续滴注对于预防新生儿应用PICC输注过程中的堵管具有显著效果,对于预防因血栓和堵管而发生的拔管有显著效果。结论新生儿通过PICC导管输注肠外营养液时,适当使用肝素稀释液对于减少堵管、延长导管使用时间有一定效果。Objective To evaluate the effectiveness of heparin catheters（PICC） in neonates. Methods The randomized controlled in maintaining the patency of peripherally inserted central trials（RCTs） were searched through JBI Database of Systematic Review,MEDLINE（from January 1966 to June 2011）,EMbase（from January 1989 to June 2011）,CINAHL（from January 1982 to June 2011）,CBMdisc（from January 1978 to June 2011）,CNKI（from January 1994 to June 2011） and Cochrane Database of Systematic Review. The quality of RCTs was critically appraised and data were extracted by 3 reviewers independently. Meta-analysis was conducted for the included RCTs by using Revman 5.0 software. Results Six RCTs were included. Meta analysis indicated that continuous heparin infusion could prevent catheter occlusion in neonates with PICC and in neonates with total parenteral nutrition（TPN） through PICC. Moreover,continuous heparin infusion could prevent the incidence of accidental extuhation due to thrombosis and catheter occlusion in neonates with PICC. Conclusion Heparin infusion can effectively prevent catheter occlusion in neonates with TPN through PICC and prolong the usability of PICC.

关 键 词：婴儿 新生 导管插入术 外周 肝素 

分 类 号：R472[医药卫生—护理学]