品管圈在PICC置管术后并发症应用效果的Meta分析

Meta analysis on application effect of quality control circle in complications after PICC catheterization

目的系统评价应用品管圈在经外周置入中心静脉导管(PICC)置管术后控制并发症的应用效果。方法计算机检索Cochrane Library、PubMed、EMBASE、中国生物医学文献数据库(CBM)、中国知网(CNKI)、维普(VIP)和万方数据资源等系统中关于品管圈在PICC置管术后应用效果的随机对照试验,按照纳入和排除标准选取文献。2名评价者独立检索、筛查文献、提取数据、评价纳入文献的方法学质量并交叉核对后,用RevMan 5.3软件行Meta分析。结果共检索文献7 919篇,最终纳入14项研究共2 728例患者。干预组PICC静脉炎、导管堵塞、非计划性拔管、导管相关性血流感染发生率均低于对照组,且差异有统计学意义(OR=0.28,95%CI:0.16~0.48,P<0.01;OR=0.27,95%CI:0.17~0.42,P<0.01;OR=0.27,95%CI:0.18~0.39,P<0.01;OR=0.25,95%CI:0.13~0.49,P<0.01)。结论应用品管圈有助于降低PICC置管术后并发症的发生率。

Objective To systematically evaluate the application effect of the quality control circle(QCC)in the complications after PICC catheterization.Methods The randomized controlled trials(RCTs)on the application effect of QCC after PICC catheterization were retrieved from the Cochane library,PubMed,EMBASE,Chinese Biomedical literature Database(CBM),China Academic Journal Full-text Database(CNKI),VIP and Wangfang Database by computer.The literatures were selected according to the inclusion and exclusion criteria.The two valuators independently retrieved and screened the literatures,extracted the data,evaluated the methodological quality of included literatures and conducted the cross check.Then the meta analysis was performed by using RevMan 5.3 software.Results A total of 7 914 articles were retrieved,finally 14 RCTs were included,involving 2 728 patients.The occurrence rates of phlebitis,catheter obstruction,unplanned extubation and catheter-related blood flow infection in the intervention group were lower than those in the control group,the difference was statistically significant(OR=0.28,95%CI:0.16-0.48,P<0.01;OR=0.27,95%CI:0.17-0.42,P<0.01,OR=0.27,95%CI:0.18-0.39,P<0.01;OR=0.25,95%CI:0.13-0.49,P<0.01).Conclusion Using QCC is conducive to reduce the complication incidence rate after PICC catheterization.