抗感染导管预防导管相关性血流感染效果的系统评价

Effectiveness of Antimicrobial-coated Central Venous Catheters on Catheter-related Bloodstream Infections:A Systematic Review

目的系统评价肿瘤患者使用抗感染导管预防导管相关性血流感染(CRBSI)的效果。方法计算机检索Cochrane图书馆、中文、英文数据库中关于肿瘤患者使用抗感染导管的随机对照试验,同时筛检纳入文献的参考文献;对文献质量进行严格评价和资料提取,对符合质量标准的RCT进行荟萃分析。结果共纳入6个RCT;显示抗感染导管能显著降低CRBSI的发生率(P<0.001),1个RCT显示涂抗菌药物的导管能有效预防CRBSI的发生(P=0.01),5个RCT显示涂消毒剂的导管能有效预防CRBSI的发生(P=0.02)。结论由于纳入研究少,均存在方法学上的不足,没有足够证据认为抗感染导管能够有效预防肿瘤患者发生CRBSI。

OBJECTIVE To assess the effect of antimicrobial-coated central venous catheters（AC） on catheter-related bloodstream infections（CRBSI） in cancer patients.METHODS Searched the Cochrane Library,Wiley InterScience,PUBMED,EBSCO,Elsevier,Springer,CBM,CNKI and WANFANG databases to collect randomized controlled trials（RCTs）.The quality of RCTs was critically appraised and data were extracted by 2 reviewers independently.Meta-analyses were conducted for the eligible RCTs.RESULTS Six RCTs were includedand indicated that the prevalence of CRBSI could be lowered evidently by AC（P〈0.001）.AC were significantly more effective than the standard polyurethane uncoated catheters in one RCT（P=0.01）.The antiseptic coated catheters showed significant reductions in risk of CRBSI compared with standard ones in five RCTs（P=0.02）.CONCLUSIONS No sufficient available scientific evidence are obtaired for preventing CRBSI by the use of AC in cancer patients,because the trials available for this mete-analysis are too few and with low qualities.