5种不同血管通路对外周血干细胞采集结果影响的网状Meta分析  

Five different vascular accesses on the outcome in peripheral blood stem cells collection:a network Meta-analysis

作　　者：程红 方思施 曾咏祺 沈莎莎 钟成丽[2] Cheng Hong;Fang Sishi;Zeng Yongqi;Shen Shasha;Zhong Chengli(Nursing Department,the First Affiliated Hospital of Zhejiang University,Hangzhou 310009,China;Department of Hematology,the First Affiliated Hospital of Zhejiang University,Hangzhou 310009,China)

机构地区：[1]浙江大学医学院附属第一医院护理部,杭州310009 [2]浙江大学医学院附属第一医院血液内科,杭州310009

出　　处：《中国实用护理杂志》2024年第8期634-640,F0003,共8页Chinese Journal of Practical Nursing

摘　　要：目的采用网状Meta分析评价不同血管通路对外周血干细胞采集效果的影响,为临床医护人员选择最佳血管通路提供参考。方法系统检索中国知网、维普全文数据库、万方数据知识服务平台、中国生物医学文献数据库、PubMed、Web of Science、EMbase、Cochrane Library,检索时间均为建库至2023年4月15日。由2名评价员独立筛选文献、提取内容并进行文献质量评价。采用R4.2.2软件和Addis-1.16.6软件进进行网状Meta分析。结果共纳入研究7篇,所涉及的血管通路方法有5种,分别为动-静脉、经股静脉置入中心静脉导管(FV-CVC)、经颈内静脉置入中心静脉导管(IJV-CVC)、外周动脉、外周静脉。与外周静脉相比,不同血管通路在外周血干细胞采集过程中对CD34细胞数差异均无统计学意义(均P>0.05);在单次血容量处理时间上,外周静脉与IJV-CVC相比,差异有统计学意义(MD=14.80,95%CI 2.70~22.38,P<0.05);累计概率图曲线下面积显示,在CD34细胞数上,FV-CVC>IJV-CVC>动-静脉>外周动脉>外周静脉通路;对于单次血容量处理时间与单核细胞数来说,外周动脉最优,其次为外周静脉。结论研究结果表明,外周动脉可作为外周血干细胞采集中最佳血管通路,为建立外周血干细胞采集的血管通路开辟了新的途径,但还需大样本高质量临床研究证实。Objective To analyze the effect of different vascular access on the outcome in peripheral blood stem cells collection by a network Meta-analysis,and to provide a reference for clinical medical staff to select the best vascular access.Methods A systematic search was carried out in Chinese Knowledge Infrastructure database(CNKI),Wanfang Database,VIP Database,Chinese Biomedical Literature Database,Cochrane Library,Web of Science,PubMed,Embase,from inception until April 15,2023.Two researchers independently screened literature and extracted data.Bayesian network meta-analysis was performed using R4.2.2 and Addis-1.16.6 softwares.Results A total 7 pieces of research were included,5 vascular access methods were peripheral artery,peripheral vein,artery-vein,femoral vein-central venous catheter(FV-CVC),and internal jugular vein-CVC(IJV-CVC).The results showed that compared with the peripheral veins,there was no significant difference on CD34 cells between other vascular accesses in the primary outcome measure when collected peripheral blood stem cell collection.On the single blood volume treatment time,peripheral vein and IJV-CVC were statistically significant(MD=14.80,95%CI 2.70-22.38,P<0.05).The SUCRA ranking probability chart showed that on CD34 cells,FV-CVC>IJV-CVC>artery-vein>peripheral artery>peripheral vein access;for a single blood volume treatment time and monocyte number,peripheral artery was superior and the next was peripheral vein.Conclusions Current evidence suggested that Peripheral artery may be the best vascular access in peripheral blood stem cells collection,which opens a new way to establish the vascular access for peripheral blood stem cells collection,but it needs to be confirmed by large clinic trials.

关 键 词：造血干细胞 血样采集 血管通路设备 网状Meta分析 

分 类 号：R472[医药卫生—护理学]