阿司匹林预防PICC相关性血栓的系统评价  

Efficacy of aspirin in preventing peripherally inserted central venous catheter-related thrombosis： a systematic review

作　　者：王旭梅[1] 刘丽丽[2] 吴心怡[2] 王莉[1] Wang Xumei Liu Lili Wu Xinyi Wang Li(Hematology and Oncology Center, Beijing Children＇s Hospital, Capital Medical University, Beijing 100045, China Nursing Department, Beijing Children＇s Hospital, Capital Medical University, Beijing 100045, China)

机构地区：[1]首都医科大学附属北京儿童医院血液肿瘤中心,100045 [2]首都医科大学附属北京儿童医院护理部,100045

出　　处：《中华现代护理杂志》2017年第10期1361-1367,共7页Chinese Journal of Modern Nursing

摘　　要：目的 本研究运用Cochrane系统评价方法 ,评价阿司匹林对预防PICC相关性血栓的效果.方法计算机检索中国知网全文数据库（CNKI）、中国维普全文数据库（VIP）、万方数据资源系统、Cochrane Database of Systematic Reviews、CINAHL护理全文数据库、Elsevier、PubMed、EBSCO全文数据库,辅以互联网络检索,收集所有探讨阿司匹林预防PICC相关性血栓的随机对照试验、半随机对照试验和病例对照研究,由2名研究员按照纳入和排除标准筛选文献并提取资料,参考Cochrane Handbook 5.1.0评价标准和Newscastle-Ottawa scale进行质量评价,使用RevMan5.0软件进行Meta分析或仅进行描述性分析.结果 共纳入9篇文章（3064例患者）,3篇为随机对照试验,5篇为半随机对照试验,1篇为病例对照研究,试验组血栓发生率低于对照组（OR=3.66,95%CI=0.42~0.77,P=0.0002）;试验组1周内血栓发生率低于对照组（OR=2.99,95%CI=0.14~0.67,P=0.003）;试验组非计划性拔管发生率低于对照组2.1%（OR=2.63,95%CI=0.04~0.63,P=0.008）.试验组静脉炎发生率低于对照组（OR=4.47,95%CI=0.16~0.49,P〈0.05）.结论 阿司匹林可以用于预防PICC相关的血栓,但是其不良反应需要密切监测.ObjectiveTo evaluate the effect of aspirin in preventing peripherally inserted central venous catheter （PICC）-related thrombosis by Cochrane systematic review method.Methods The relevant randomized controlled trials,quasi-randomized controlled trials and case-control study were searched in the Wang Fang Databases, VIP, CNKI, CINAHL, Elsevier, Cochrane Database of Systematic Reviews, EBSCO and Pub Med. The studies were selected according to the inclusion and exclusion criteria by two reviewers, and the quality of included studies was evaluated according to Cochrane Handbook 5.1.0 and Newscastle-Ottawa scale. Meta-analysis was conducted by using RevMan5.0.Results A total of 9 articles included three randomized controlled trials, five quasi-randomized controlled trials and one case-control study involving 3064 patients. The results of Meta-analysis showed that the control group had a significantly higher incidence of thrombosis than experimental group（OR=3.66,95%CI=0.42-0.77,P=0.0002）; control group had a significantly higher incidence of thrombosis within one week than experimental group（OR=2.99,95%CI=0.14-0.67,P=0.003）; control group had a significantly higher incidence of unplanned removal than experimental group （OR=2.63,95%CI=0.04-0.63,P=0.008）. Control group had a significantly higher incidence ofphlebitis than experimental group （OR=4.47,95%CI=0.16-0.49,P〈0.05）.Conclusions Aspirin can be used as an efficient way to prevent PICC associated thrombosis, while the side effect should be closely observed.

关 键 词：阿司匹林 血栓 META分析 

分 类 号：R472[医药卫生—护理学]