肝素稀释液预防成年患者PICC堵塞的Meta分析

目的评价使用肝素稀释液对预防成年患者PICC堵管的效果。方法计算机检索Cochrane图书馆、JBI图书馆,MEDLINE,Web of Knowledge,OVID,中国生物医学文献数据库(CBMdic),中国期刊全文数据库(CNKI)中符合纳入排除标准的随机对照研究、类实验性研究、队列研究和病例对照研究,检索时限均为建库至2013年6月,由3名研究者对文献进行严格筛选、质量评价,提取资料,对符合质量标准的使用RevMan 5.0对结局指标进行了分析和描述。结果共纳入2项随机对照研究,2项类实验性研究,Meta分析结果显示,肝素稀释液间断封管对减少成年人PICC堵管没有显著效果(OR=1.18,95%CI为0.69~2.04,P0.05)。结论相比于生理盐水封管而言,使用肝素稀释液封管预防成年人PICC堵管的效果不明显,肝素液的最佳有效浓度尚无定论,有待进一步研究。

Effects of Heparin Locking on Prevention of Occlusion of Peripherally Inserted Central Catheters for Adults：A Meta Analysis

Objective To evaluate the effect of heparin locking on preventing occlusion of peripherally inserted central catheters （PICC） for adults. Methods The Cochrane Library （2013）, JBI Library and the database of MEDLINE, Web of Knowledge, OVID, CBMdic, CNKI were searched to collect randomized control trials （RCTs）. The quality of RCTs was critically appraised and data were extracted by three reviewers independently then meta-analysis was conducted by Revman5.0. Results Four RCTs were included which showed heparin flushing had no significant effect on preventing occlusionOR=1.18, 95%CI（0.69,2.04）, P〈0.05]. Conclusion Compared with normal saline, heparin locking has no significant effect on the prevention of occlusion of PICC, the effective concentration of which needs further research.