应用抗凝药物预防PICC相关性血栓形成的Meta分析

Meta Analysis of Anticoagulant Drugs for Prevention of PICC Associated Thrombosis

目的:探讨通过meta分析PICC置管患者应用抗凝治疗,为临床预防置管后静脉血栓形成提供依据。方法:使用计算机检索2000~2016年Cochrane Library、Pub Med、中国生物医学数据库(CBM)、中国期刊全文数据库(CNKI)中,有关抗凝药物治疗预防PICC置管患者静脉血栓发生效果的随机对照试验(RCT)。按照循证医学系统评价方法选取文献,对选取的文献采用Cochrane协作网Rev Man5.3软件进行统计分析。结果:最终纳入10个RCT,共2 269例PICC置管患者。Meta分析结果显示,对PICC置管患者进行抗凝药物预防可有效减少导管相关性血栓发生(RR=0.24,P<0.01);其中2项试验结果显示,两组抗凝治疗延长PICC留置时间比较差异有统计学意义(P<0.01)。结论:对PICC患者置管期间给予抗凝治疗,可有效预防导管相关性血栓发生,延长PICC留置时间,减轻不良反应。

Objective：To investigate the application of anticoagulant therapy in patients with PICC catheter by meta analysis ,and to pro-vide evidence for the prevention of venous thrombosis after catheter placement .Method：Randomized controlled trials（RCT）on the effect of anticoagulant therapy on the prevention of venous thrombosis in patients with PICC catheter were retrieved by using the computer to search the Cochrane Library,PubMed,China biomedical database（CBM）,China Journal Full-text Database（CNKI）from 2000 to 2016.The litera-ture was selected according to the evaluation method of evidence-based medicine system ,and was analyzed by Cochrane software RevMan 5.3.Results：We included 10 randomized controlled trials ,a total of 2269 cases of patients with PICC catheter .The results of Meta analysis showed that the PICC catheter in patients with anticoagulant drug prevention can effectively reduce the incidence of catheter -related throm-bosis（RR=0.24,P〈0.01）;the results of two trials showed that there was a significant difference between two groups in prolonging the duration of PICC treatment（P〈0.01）.Conclusion：Anticoagulant therapy for PICC patients during catheter placement can effectively pre -vent catheter related thrombosis ,prolong the duration of PICC stay ,and reduce adverse reactions.