Meta分析庆大霉素封管液预防血透患者中心静脉导管相关感染  

Meta-analysis of gentamicin lock solution in prevention of central venous catheter-related infections in hemodialysis patients

作　　者：周祥 张庆庆[1] 张雪琴[1] 王晓宇[1] 姜鸿[1] Xiang Zhou;Qingqing Zhang;Xueqin Zhang;Xiaoyu Wang;Hong Jiang(Department of Nephrology,People′s Hospital of Xinjiang Uygur Autonomous Region,Xinjiang Clinical Research Center of Nephrology,Urumqi 832000,Xinjiang Uygur Autonomous Region,China)

机构地区：[1]新疆维吾尔自治区人民医院肾病科、新疆肾脏病临床医学研究中心,832000

出　　处：《中华肾病研究电子杂志》2024年第4期201-206,共6页Chinese Journal of Kidney Disease Investigation（Electronic Edition）

基　　金：新疆护理学会科研项目(2022XH06);新疆维吾尔自治区人民医院院内项目(20190428)。

摘　　要：目的系统评价庆大霉素封管液预防血透患者中心静脉导管相关感染的效果。方法检索Cochrane Library、PubMed、Web of Science、Joanna Briggs Institute Library、CINAHL Complete、中国知网、万方及维普数据库,选择血透患者单独应用庆大霉素或肝素封管液的随机对照试验。根据Cochrane Reviewer′s Handbook 5.0推荐标准进行质量评价,由2位研究者筛选文献,采用RevMan5.3软件进行Meta分析。结果本研究共纳入11项随机对照试验。Meta分析结果显示,单独应用庆大霉素封管的血透患者中心静脉导管相关感染发生率低于单独应用肝素封管(OR=0.34,95%CI:0.23~0.51,I^(2)=18%,P<0.001)。单独应用庆大霉素封管的血透患者中心静脉导管内血栓形成发生率低于单独肝素封管(OR=0.16,95%CI:0.10~0.27,I2=18%,P<0.001)。结论本研究结果提示,庆大霉素封管液可降低血透患者的中心静脉导管相关感染发生率以及导管内血栓形成的风险,对临床工作具有一定的参考价值。Objective To evaluate the efficacy of the application of gentamicin lock solution in prevention of central venous catheter-related infections in patients with hemodialysis.Methods Retrievals were made in the Cochrane Library,PubMed,Web of Science,Joanna Briggs Institute Library,CINAHL Complete,CNKI,Wanfang,and VIP databases.Randomized controlled trials were selected in hemodialysis patients treated with gentamicin or heparin lock solution alone.Quality assessment was conducted according to the recommended standard by Cochrane Reviewer′s Handbook 5.0.The literature was screened by two researchers,and meta-analysis was performed with the RevMan5.3 software.Results This study included 11 randomized controlled trials.The results of the meta-analysis showed that the incidence of central venous catheter-related infections in patients treated with gentamicin lock solution alone was lower than that with heparin lock solution alone(OR=0.34,95%CI:0.23-0.51,I^(2)=18%,P<0.001).The incidence of thrombosis formation in the central venous catheters of hemodialysis patients treated with gentamicin lock solution alone was lower than that of with heparin lock solution alone(OR=0.16,95%CI:0.10-0.27,I2=18%,P<0.001).Conclusion The results of this study suggested that gentamicin lock solution could reduce the incidence of central venous catheter-related infections and the risk of intra-catheter thrombosis in patients with hemodialysis,which may have certain reference value in clinical work.

关 键 词：庆大霉素 肝素 导管相关感染 中心静脉导管 

分 类 号：R692[医药卫生—泌尿科学] R54[医药卫生—外科学]