肝素用于小儿中心静脉导管维护系统评价再评价*

目的：对肝素用于小儿中心静脉导管维护有效性及安全性的系统评价进行再评价。方法：计算机检索Cochrane Library、EMBASE、Pubmed等数据库，检索时间自建库至2017年1月，检索肝素在小儿中心静脉导管静脉维护中应用的有效性及安全性相关的系统评价和Mete分析。采用AMSTAR工具评价纳入研究的方法学质量，GRADE系统对结局指标进行质量评价。结果：最终纳入7篇系统评价/Meta分析。对纳入文献进行文献质量评价,AMSTAR评价显示，6篇为高质量，1篇为中等质量。GRADE评价显示，7个结局指标的证据集群质量等级3个为高，1个为中，3个为低。结论：肝素对维护小儿中心静脉导管通畅性可能有效，但其证据质量有待进一步提高。

Re-evaluation of heparin for pediatric central venous catheter maintenance systematic review

Objective: To perform a re-evaluation of the systematic review on efficacy and safety of heparin for pediatric central venous catheter maintenance. Methods: A literature search of Cochrane Library, EMBASE, Pubmed from their inception to January 2017.Hand searching of articles on systematic review and Meta analysis related to efficacy and safety of heparin for pediatric central venous catheter maintenance. Use AMSTAR tools to evaluate the methodology quality of the included studies and assess the quality of outcome indicators by the GRADE system. Results: 7 articles on systematic review and Meta analysis were included. 6 articles met the criteria of high quality and 1 medium based on AMSTAR evaluation. GRADE evaluation showed that there were 3 high, 1 medium and 3 low level articles on the evidence cluster quality of 7 outcome indicators. Conclusion: Heparin may be effective in maintaining patency of venous catheters in children, but the quality of evidence needs to be further improved.