预充式导管冲洗器临床效果Meta分析

doi:10.3969/j.issn.1672-1756.2017.11.023

预充式导管冲洗器临床效果Meta分析

田磊周挺马爱霞刘强

中国药科大学国际医药商学院，211198 南京市

出版日期:2017-11-25 发布日期:2017-11-25

The clinical effectiveness of pre-filled saline syringes: a Meta-analysis

Online:2017-11-25 Published:2017-11-25

摘要/Abstract

摘要： 目的：系统性评价预充式导管冲洗器与手工配液冲、封管对比的患者临床效果及对医护人员的影响。方法：以“导管冲洗器”“flush”“pre-filled saline syringes”或“pre-loaded syringes”作为检索词在PubMed、The Cochrane Library、Embase、CNKI、Wanfang Data和VIP数据库检索建库至2015年3月发表的相关文献；对纳入文献进行质量评估后使用RevMan 5.3进行Meta分析。结果：最终纳入46篇文献（3篇英文，43篇中文)进行Meta分析。在临床患者获益方面，导管相关性血流感染发生率：OR=0.23，95% CI（0.16，0.34），P<0.001；堵管发生率： OR=0.38，95% CI（0.24，0.60），P<0.001；外周或中心静脉置管保留时间： MD=0.51，95% CI（0.34，0.67）天，P<0.001。在医护人员获益方面，针刺伤发生率： OR=0.21，95% CI（0.07，0.61），P=0.004；医护人员冲、封管操作时间：MD=-1.37，95% CI（-1.56，-1.18)分钟，P<0.001。结论：预充式导管冲洗器与手工配液冲、封管比，能够显著降低导管相关性血流感染、堵管的发生率并延长外周或中心静脉置管导管保留时间，增加了临床上的患者获益；能够显著降低医护人员针刺伤发生率并缩短医护人员冲、封管操作时间，增加了医护人员临床操作的获益。预充式导管冲洗器具有较好的临床运用价值。

Abstract: Objective: To evaluate the clinical effectiveness for patients and benefits for medical personnel of pre-filled saline syringes compared with manual operation. Methods: We searched public literatures in Pubmed, the Cochrane Library, Embase, CNKI, WanFang Data and VIP databases for the period up to March 2015. The search terms used were: flush, pre-filled saline syringes and pre-loaded syringes. RevMan 5.3 Software was used to conduct the review after the quality assessment of included studies. Results: In total, 46 studies were included for a further analysis. As for patients' benefits, Meta-analysis results showed significant greater effects of pre-filled saline syringes versus manual operation in reducing catheter-related blood stream infections (odds ration [OR] 0.23, 95% CI : 0.16, 0.34, P<0.001), occlusions (OR 0.38, 95% CI : 0.24, 0.60, P<0.001), and extending catheter indwell time (Mean difference [MD] 0.51d, 95% CI : 0.34, 0.67, P<0.001). As for medical personnel's benefits, this analysis also represented evidence of pre-filled saline syringes in reducing the rate of needlestick injury (OR 0.21, 95% CI : 0.07, 0.61, P=0.004) and medical personnel's operation time (MD -1.37min, 95% CI : -1.56, -1.18, P<0.001) when compared with manual operation. Conclusion: Compared with manual operation, pre-filled saline syringe is a better option for patients to reduce the rate of catheter-related bloodstream infection, occlusions and extend catheter indwell time, and for health workers to reduce the rate of needlestick injury and operation time as well. It's meaningful to apply pre-filled saline syringes in clinic.

田磊周挺马爱霞刘强. 预充式导管冲洗器临床效果Meta分析[J]. , 2017, 17(11): 1545-1555.