不同止血方法应用于脑血管介入诊疗效果的Meta分析  

Effect of different hemostasis methods in patients with cerebrovascular interventional diagnosis and treatment:a meta-analysis

作　　者：孙迟[1] 卫彬彬 廖雯俊[1] SUN Chi;WEI Binbin;LIAO Wenjun(The Second Affiliated Hospital of Nanchang University,Jiangxi 330006 China)

机构地区：[1]南昌大学第二附属医院,330006

出　　处：《全科护理》2023年第12期1595-1601,共7页Chinese General Practice Nursing

基　　金：江西省卫生健康委员会科技计划课题项目,编号:202310537。

摘　　要：目的:评价经股动脉穿刺脑血管介入诊疗术后动脉压迫止血器与血管闭合器的应用效果。方法:检索万方数据库、中国生物医学文献数据库(CBM)、维普中文科技期刊数据库(VIP)、中国知网(CNKI)和PubMed、Cochrane Library、Embase从建库至2021年2月的相关中英文文献,所检文献按纳入排除标准进行筛选后遵照Cochrane手册(5.1.0版)评价文献质量,应用RevMan 5.3软件进行Meta分析或描述性分析。结果:最终纳入7个研究,共698例病人。Meta分析结果显示,血管闭合器与动脉压迫器的止血成功率无明显差异[RR=1.01,95%CI(0.96,1.07),P=0.59],血管闭合器较动脉压迫器减少了渗血或血肿[RR=0.20,95%CI(0.10,0.40),P<0.00001]、排尿困难[RR=0.28,95%CI(0.15,0.52),P<0.0001]、腰背疼痛[RR=0.21,95%CI(0.13,0.33),P<0.00001]、血压下降[RR=0.19,95%CI(0.06,0.62),P=0.006]的发生,病人术后6 h的舒适度提高[MD=6.05,95%CI(2.36,9.75),P=0.001]。结论:经股动脉穿刺脑血管介入诊疗术后应用血管闭合器止血效果可靠,且较动脉压迫器能减少并发症发生的同时提高病人舒适度,但缺乏对这两类止血装置应用的远期预后及经济学方面的综合评价。Objective:To evaluate the application effect of arterial compression hemostasis device and vascular closure device in patients with cerebrovascular interventional diagnosis and treatment by femoral artery puncture.Methods:Relevant Chinese and English literature was retrieved from the Wanfang Database,China Biology Medicine disc(CBM),VIP Chinese Science and Technology Journal Database,China National Knowledge Infrastructure(CNKI),PubMed,Cochrane Library,and EMbase from the establishment of the database to February 2021.After screening the retrieved literature based on the inclusion and exclusion criteria,the quality of the literature was evaluated according to the Cochrane Handbook(Version 5.1.0).The RevMan 5.3 software was used for meta-analysis or descriptive analysis.Results:A total of 7 studies were finally included,involving 698 patients.The results of the meta-analysis showed no significant difference in the success rate of hemostasis between the arterial compression hemostasis device and vascular closure device[RR=1.01,95%CI(0.96,1.07),P=0.59].The vascular closure device reduced the bleeding or hematoma[RR=0.20,95%CI(0.10,0.40),P<0.00001],dysuria[RR=0.28,95%CI(0.15,0.52),P<0.0001],low back pain[RR=0.21,95%CI(0.13,0.33),P<0.00001],the incident of blood pressure drop[RR=0.19,95%CI(0.06,0.62),P=0.006],which improved the postoperative comfort of patients[MD=6.05,95%CI(2.36,9.75),P=0.001].Conclusions:The hemostatic effect of blood vessel closure device after femoral artery puncture cerebrovascular interventional diagnosis and treatment is reliable,and compared with artery compression device,it can reduce the occurrence of complications and improve the comfort level of patients,but there is a lack of comprehensive evaluation on the long-term prognosis,economics and other aspects of the application of these two kinds of hemostatic devices.

关 键 词：止血 脑血管介入 血管闭合器 动脉压迫器 META分析 

分 类 号：R473.74[医药卫生—护理学]