动脉压迫止血器应用于肝癌介入术后患者效果的Meta分析

The effect of arterial compression hemostasis device on liver cancer patients after interventional therapy:a meta-analysis

目的评价经股动脉穿刺肝癌介入术后应用动脉压迫止血器的效果。方法检索Cochrane Library、Pub Med、EMbase、中国知网和万方数据知识服务平台等数据库中关于经股动脉穿刺肝癌介入术后应用动脉压迫止血器的随机对照试验。采用Cochrane Handbook(5.0.1)对文献质量进行评价,并采用Rev Man 5.3软件进行Meta分析。结果共纳入9项研究。6项分析结果显示,使用动脉压迫止血器较常规方法能够缩短压迫止血时间[MD=-4.55,P<0.001]和肢体制动时间[MD=-15.98,P<0.001];使用动脉压迫止血器能够降低局部渗血(8项)[RR=0.27,P<0.001]、血肿形成(8项)[RR=0.30,P<0.001]和皮肤瘀斑(6项)[RR=0.30,P<0.001]发生率。结论肝癌介入术后患者应用动脉压迫止血器相对于常规方法在缩短压迫止血时间和肢体制动时间、降低血管并发症方面效果明显,但是对其可能出现的皮肤瘀斑仍需给予足够重视。

Objective To evaluate the effect of arterial compression hemostasis device on liver cancer patients after interventional therapy. Methods Databases such as Coehrane Library,PubMed,EMbase,CNKI and WanFang were searched to recruit randomized controlled trials in Chinese or English. The effects of hemostatic compression device were determined by meta-analysis with RevMan 5.3. Results Totally 9 studies were finally recruited. 6 studies concerned compression hemostasia time and limb immobilization time. The meta-analysis results showed that, using artery compression hemostasis device compared with conventional manual compression combining with sand- bags was able to shorten the compression hemostasia time[MD=-4.55,P〈0.001] and the time of limb immobilization [MD=-12.30,P〈O.OO1]. Puncture site bleeding,hematoma and ecchymosis were included in 8 studies. Meta-analysis showed that,using artery compression hemostasis device was able to reduce local bleeding incidence[RR=0.27,P〈0.001], hematoma formation incidence [RR=0.30,P〈0.001] and skin eechymosis incidence （6 studies）[RR=0.30,P〈0.001]. Conclusion Arterial compression hemostasis device which used in liver cancer patients after interventional therapy can reduce the time of compression hemostasis and the time of the body＇s brake,reduce the incidence rate of vas- cular complications. But enough attentions should be paid to adverse reactions caused by it.