局部按压对低分子肝素皮下注射相关影响的系统评价  

Systematic evaluation on influence of local pressing on LMWH subcutaneous injection

作　　者：黄艳林[1] 付丽[1] 李月梅[2] 陈江琼 徐薇薇[2] Huang Yanlin Fu Li Li Yuemei Chen Jiangqiong Xu Weiwei Nursing(Department, the Second Hospital of Tianjin Medical University, Tianjin 300211, China （Hnang YL, Fu L Graduate School of Tianjin Medical University, Tianjin 300070, China （ Li YM, Chen JQ, Xu WW)

机构地区：[1]天津医科大学第二医院护理部,300211 [2]天津医科大学研究生院,300070

出　　处：《中华现代护理杂志》2016年第35期5114-5119,共6页Chinese Journal of Modern Nursing

摘　　要：目的系统评价低分子肝素皮下注射后按压与否对皮下出血的影响。方法通过计算机检索Cochrane图书馆（CENTRAL）、PubMed、EMbase、中国学术期刊全文数据库（CNKI），中国生物医学文献数据库（CBM），收集所有关于低分子肝素皮下注射后按压时长相关的临床对照试验，检索过程由2名研究人员独立进行，通过Cochrane协作网偏倚风险评价工具对文献独立进行严格质量筛选、评价，采用RevMan 5.3软件进行数据合并分析。结果研究共纳入9篇临床对照研究，皆为中文文献，按压组累计注射2814例次，不按压组累计注射2801例次。Meta分析中重度皮下出血合并RR值为0.7，95%置信区间为（0.49-0.99），差异有统计学意义（P〈0.05）；亚组分析发现结局指标评价尺度为各研究之间异质性来源，分析结果支持不按压的积极作用。结论低分子肝素皮下注射后局部按压时间对皮下出血有一定影响，注射后不予按压并不增加局部中重度皮下出血发生率。Objective To systematically evaluate, after subcutaneous injection of low-molecular- weight-heparin（ LMWH）, the effect of whether pressing or not on bruising. Methods All controlled clinical trails about pressing duration after subcutaneous injection of LMWH were collected by searching Cochrane Library （CENTRAL）, PubMed, EMbase, CNKI, and Chinese Biomedical Literature Database （CBM）. Two researchers, working independently, extracted strictly and assessed the data by the bias risk evaluation tool of the Cochrane collaboration network, with the data combined and analyzed by RevMan 5. 3 software. Results Nine clinical controlled trials that were all Chinese literatures were included, in which 2 814 injections were reported in total in the pressing group while 2 801 ones in non-pressing group. It was shown in Meta analysis that for severe subcutaneous bleeding, RR = 0.7, 95% CI（0.49-0.99） , （ P〈0.05 ） ; subgroup analysis revealed that evaluation criterion of the outcome indicators was the sources of heterogeneity among the included studies, and the results supported the positive effect of not pressing. Conclusions Pressing duration has an impact on bruising after subcutaneous LMWH injections. No pressing after injection does not increase the incidence rate of local moderate or severe subcutaneous bleeding.

关 键 词：低分子肝素 皮下注射 按压时间 皮下出血 META分析 

分 类 号：R472[医药卫生—护理学]