人体手背掌指关节处静脉逆向穿刺技术的Meta分析

目的比较逆向穿刺与顺向穿刺的一次穿刺成功率和稳定性,评价掌指关节处静脉输液逆向穿刺的可行性。方法检索MEDLINE、COCHRANE图书馆数据库、中国期刊全文数据库(CNKI)、重庆维普资讯中文科技期刊数据库(VIP)以及万方数据库,纳入所有关于人体手背掌指关节处逆向穿刺的临床试验,采用RevMan5.1软件分析数据。结果共纳入14篇文献,与相同部位的顺向穿刺比较,逆向穿刺的成功率高于顺向穿刺(OR=4.46,95%CI:2.71～7.32,P<0.01);逆向穿刺药液渗漏发生率低于顺向穿刺(OR=0.26,95%CI:0.19～0.34,P<0.01)。结论掌指关节处静脉逆向穿刺在穿刺成功率和稳定性上优于相同部位的顺向穿刺,可作为需要长期静脉输液治疗患者的辅助方法。

Meta-analysis of intravenous infusion by reverse puncture on dorsal surface of metacarpophalangeal joints

Objective To compare the success rate of puncture and stability of the needles by reverse venous puncture versus normal puncture on dorsal surfaces of metacarpophalangeal(MCP) joints for intravenous infusion,and to assess the feasibility of intravenous infusion by reverse puncture.Methods We retrieved all literatures on controlled clinical trials of retrograde venous infusion by reverse puncture from Medline,the Cochrane Library,the China National Knowledge Infrastructure Database,the Chongqing VIP Chinese Science and Wanfang Data.The data were analyzed by using RevMan 5.1 software.Results A total of 14 randomized controlled trials(RCTs) and controlled clinical trials(CCTs) were retrieved.Compared with the normal puncture,the success rate of reverse puncture is much higher,with statistical significance between the two puncture methods(OR=4.46,95%CI:2.71-7.32,P<0.01);the liquid leakage rate is lower,with statistical significance between the groups(OR=0.26,95%CI:0.19-0.34,P<0.01).Conclusion Reverse puncture has higher success rate,lower liquid leakage rate,which puts reverse puncture into a favorable situation for clinical utilization.