局部措施预防化学性静脉炎的网状Meta分析  

Network Meta-analysis of local measures on prevention of chemical phlebitis

作　　者：尹新博 王小开 张燕 吴小文 何彩云[1] YIN Xinbo;WANG Xiaokai;ZHANG Yan;WU Xiaowen;HE Caiyun(Hunan Normal University School of Medicine,Hunan 410013 China)

机构地区：[1]湖南师范大学医学院,410013 [2]中南大学湘雅医院,410008 [3]中南大学湘雅护理学院,410008

出　　处：《循证护理》2020年第6期481-489,共9页Chinese Evidence-Based Nursing

基　　金：2019年湖南省学位与研究生教育改革研究项目,编号:2019JGYB089。

摘　　要：[目的]采用贝叶斯网状Meta分析评价局部措施预防化学性静脉炎的效果。[方法]计算机检索PubMed、Web of Science、the Cochrane Library、中国知网、万方数据库中有关局部措施预防化学性静脉炎的随机对照试验(randomized controlled trial,RCT),检索时限为1970年1月1日—2019年7月24日,采用澳大利亚JBI循证卫生保健中心(2014)对RCT研究进行真实性评价,由2名研究者独立进行文献筛选、提取资料并评价纳入研究的偏倚风险后,采用ADDIS 1.16.5和Stata SE 15软件进行传统Meta分析与网状Meta分析。[结果]共纳入27项研究,包含3 423例输液操作。网状Meta分析结果及概率曲线图结果提示,6类局部措施预防化学性静脉炎的效果为亲水性敷料>非甾体抗炎药>抗凝血药=糖皮质激素>血管舒张药>常规护理,差异有统计学意义(P<0.05);7种亲水性敷料类及非甾体抗炎类药物中,水胶体敷料与七叶皂苷钠凝胶为最佳局部措施。[结论]现有证据显示,6类局部措施中亲水性敷料和非甾体抗炎药能较好地预防化学性静脉炎;7种亲水性敷料与非甾体抗炎药中,水胶体敷料和七叶皂苷钠凝胶是预防化学性静脉炎的最佳局部措施。Objectives:To evaluate the effect of different local measures on the prevention of chemical phlebitis by Bayesian network Meta-analysis.Methods:Randomized controlled trials about local measures to prevent chemical phlebitis,were retrieved from PubMed,Web of Science,the Cochrane Library,CNKI and the WanFang Database.The retrieval time was from January 1,1970 to July 24,2019.The authenticity of the RCTs were evaluated by the JBI evidence-based health care center(2014).Then,selection of literature,extraction of data,and evaluation of bias risk of the study were conducted by two researchers independently.And the Meta-analysis and the Network Meta-analysis were performed by using the ADDIS 1.16.5 and the Stata SE 15 software.Results:A total of 27 studies were included,invdving 3423 cases of intravenous infusion.The results of the network Meta-analysis and the probability graph suggested that the effect of 6 local measures on the prevention of chemical phlebitis were randed as follows:the hydrophilic dressing(HD)>non-steroidal anti-inflammatory drugs(NSAIDs)>anticoagulant(ATC)=glucocorticoid(Glu)>vasodilator(VAS)>usual care(UC).There were statistical difference(P<0.05);Hydrocolloid dressing(WGD)and compound sodium aescinate gel were the best external methods among 7 kinds of hydrophilic dressing and Non-steroidal anti-inflammatory drugs on the prevention of chemical phlebitis.Conclusions:The existing evidence showed that,non-steroidal anti-inflammatory drugs and hydrophilic dressing among the 6-kinds of external methods can better prevent chemical phlebitis,Hydrocolloid dressing(WGD)and compound sodium aescinate gel were the best external methods among 7 kinds of hydrophilic dressing and non-steroidal anti-inflammatory drugs on the prevention of chemical phlebitis.

关 键 词：静脉输液 化学性静脉炎 局部措施 网状Meta分析 

分 类 号：R47[医药卫生—护理学]