品管圈干预国内对肿瘤患者经外周置入中心静脉导管并发症的Meta分析

Meta-analysis of quality control circle intervention for domestic PICC complications in cancer patients

目的评价品管圈干预肿瘤患者经外周置入中心静脉导管(PICC)并发症的效果。方法计算机检索Pubmed、Cochrane图书馆、中国生物医学文献数据库、中国知网、维普科技期刊全文数据库、万方数据资源系统等数据库中有关品管圈干预肿瘤患者PICC并发症的随机对照试验(RCT),文献检索时间均从建库至2018年6月。结果共检索到9248篇文献,符合纳入标准文献共128篇,最终纳入文献6篇,纳入病例1107例。Meta分析结果显示,运用品管圈干预PICC置管可更加有效减少并发症的发生(RR=0.13,95%CI 0.09~0.18,P<0.001),发生感染与导管阻塞要远远少于对照组(RR=0.34,95%CI0.016~0.71,P<0.005);试验组血栓的发生率也明显降低(RR=0.14,95%CI 0.04~0.44,P<0.005)。结论品管圈干预PICC置管患者,其发生并发症比常规护理减少,为临床实践提供依据。

Objective To evaluate the effect of quality control circle intervention for the complications of PICC in cancer patients.Methods Database such as Pubmed, Cochrane Library, CBM, CNKI, VIP and Wanfang were researched for randomized con-trolled trials （ RCT） related to PICC complications in cancer patients.The literature search time was from the establishment of the data-base to June 2018.Results A total of 9 ,4 8 6 articles were retrieved.Of th e se ,128 standard articles were included.Finally,6 articles with 1,107 cases were included.Meta-analysis showed that the intervention of PICC catheterization was more effective in reducing the incidence of complications （RR=0.13,95%Cl=0.09 ~0.18,P 〈 0.001）.The infection and catheter obstruction in the catheter were much less than the control group （ RR=0.34,95% Cl= 016 -0.71 ,P 〈 0.005 ） .The incidence of thrombosis in the application of the quality control circle was also significandy reduced （RR=0.14.95% Cl=0.04 ~0.44,P 〈 0.005） .Conclusion The quality control of patients with PICC catheterization has reduced complications when compared with routine care.It provides a basis for our clinical practice.