PICC导管腔内心电图定位效果及并发症的Meta分析  

Meta-analysis of PICC catheter endoluminal electrocardiogram as efficacy and complications

作　　者：王苏兰[1] 侯志敏 贺小峰[1] 刘华[1] WANG Su-lan;HOU Zhi-min;HE Xiao-feng;LIU Hua(Department of Peace Hospital, Changzhi Medical College, Shanxi Province, Changzhi 046000, Chin)

机构地区：[1]山西省长治医学院附属和平医院,长治046000

出　　处：《当代护士（上旬刊）》2018年第6期1-5,共5页Modern Nurse

摘　　要：目的探讨PICC置管时采用X线胸片定位法与腔内心电图定位法的效果及并发症发生率的差异。方法检索国内外有关PICC置管时采用X线胸片定位法与腔内心电图定位法观察效果的文献。计数资料采用相对危险度(risk ration,RR)和95%的可信区间(confidence interval,CI)进行合并分析,计量资料采用加权均数差(weighted mean difference,WMD)及95%CI进行合并分析。数据均采用STATA 9.0统计软件分析。结果共纳入14篇相关文献,腔内心电图组与X线组样本量分别为2260例和2237例。Meta分析结果显示:腔内心电图定位组上腔静脉到位率高于X线组(RR=1.11,95%CI=1.09~1.13,P<0.001);腔内心电图定位组最佳位置到位率高于X线组(RR=1.17,95%CI=1.08~1.28,P<0.001);腔内心电图定位组机械性静脉炎发生率与X线组相比较,差异无统计学意义(RR=0.37,95%CI=0.06~2.17,P=0.270)。结论 PICC置管时采用腔内心电图定位法在上腔静脉到位率、最佳位置到位率方面具有明显优势;机械性静脉炎发生率差异无统计学意义;在本研究中平均置管时间,由于I^2=98%,异质性极大,因此需要大样本随机对照试验来比较两种方法的差异。Objective To investigate the effect of X-ray chest radiograph positioning and endocardial electrocardiogram positioning on PICC catheter placement and the differences in the incidence of complications. Methods Retrieval of relevant literature at home and abroad.Count data were analyzed using a combination of relative risk and 95% confidence intervals. Measured data were analyzed using a weighted mean difference and a 95% confidence interval selection analysis. The data were analyzed using STATA 9.0 statistical software. Results A total of 14 relevant articles were included in the study. The sample sizes of endoluminal ECG and X-ray groups were 2260 cases and 2237 cases respectively. Meta analysis results showed that the rate of superior vena cava placement in the endocardial ECG positioning group. Higher than the X-ray group(RR = 1.11,95% CI = 1.09-1.13,P〈 0.001）; the best positional placement rate in the endovascular ECG positioning group was higher than that in the X-ray group(RR = 1.17,95% CI = 1.08-1.28）(P〈 0.001）; The incidence of mechanical phlebitis in the endovascular ECG positioning group was significantly higher than that in the X-ray group(RR = 0.37,95% CI = 0.06-2.17,P =0.270）. Conclusion Intracavitary electrocardiogram positioning method was used in the treatment of superior vena cava in place rate,the best location in terms of the rate has obvious advantages; the incidence of mechanical phlebitis was statistically significant difference; the average catheterization time in the study,due to I^2= 98%,the heterogeneity is very large,so a large sample of randomized controlled trials is needed to explore the differences between the two methods.

关 键 词：PICC 腔内心电图 X线 META分析 

分 类 号：R47[医药卫生—护理学]