在新生儿中通过上肢与下肢静脉放置外围插入的中央导管:随机对照试验的元分析
Xuetang Zhao1, Yingfei Liu1, Xiaoyan Li1
1Surgical Intensive Care Unit (SICU), Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
Journal for specialists in pediatric nursing : JSPN
|November 21, 2023
概括
在新生儿中,用于外围插入中央导管 (PICC) 的下肢静脉插入提供了更高的成功率和更长的停留时间. 这种方法还可以减少感染和炎等并发症,使其成为新生儿护理的潜在首选.
科学领域:
- 新生儿重症监护室新生儿重症监护室
- 血管接入装置是指血管接入装置.
- 儿科护理 儿科护理
背景情况:
- 周围插入的中央导管 (PICC) 对于给新生儿提供药物和营养至关重要.
- 选择最佳的插入部位对于程序的成功和患者的安全至关重要.
- 关于新生儿上肢与下肢PICC放置的有限的比较数据存在.
研究的目的:
- 在新生儿中通过上肢和下肢静脉放置外围插入的中央导管 (PICC) 的疗效和安全性.
- 为新生儿群体的临床PICC护理提供基于证据的见解.
主要方法:
- 一个系统的对已发表的随机对照试验 (RCT) 的元分析.
- 在主要数据库中进行全面的文献搜索,包括Cochrane Library,PubMed,Web of Science等.
- 使用Cochrane手册标准和使用RevMan 5.3软件进行统计分析的研究的独立质量评估.
主要成果:
- 与上肢静脉相比,通过下肢静脉插入PICC显示出更高的一次性刺穿成功率 (RR=0.73) 和更长的停留时间 (MD=-3.60).
- 下肢PICC安置与手术时间缩短 (MD=10.37),估计血液损失 (MD=0.55) 和导管切口症的发生率 (RR=2.46) 相关.
- 在下肢插入的情况下,观察到与PICC相关的感染 (RR=2.82),外 (RR=2.45) 和 (RR=1.40) 的发生率明显较低,而导管阻塞率没有显著差异.
结论:
- 新生儿PICC通过下肢静脉插入,与上肢插入相比,具有若干优势.
- 下肢静脉方法可能是新生儿PICC手术的首选和更安全的选择.
- 这些发现支持通过将下肢静脉视为主要部位来优化PICC护理.
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