超声引导技术在成人桡动脉穿刺中应用效果的Meta分析

Meta-analysis of the effect of ultrasound-guided technique in radial artery puncture in adults

目的系统评价超声引导技术在成人桡动脉穿刺中的应用效果。方法检索中国知网、万方数据库、维普数据库、中国生物医学文献服务系统、PubMed、CINAHL,Cochane Library、Web of Science、Embase、临床试验数据库关于超声引导与触诊在成人桡动脉穿刺中效果比较的随机对照试验,运用RevMan 5.0软件进行Meta分析。结果共纳入11项随机对照试验研究,共2284例患者。Meta分析结果显示,超声引导可以提高成人桡动脉首次穿刺成功率[OR=3.89,95%C1(2.52,6.01),P<0.001],减少平均穿刺次数[MD=-0.98,95%CI(-1.73,-0.23),P=0.01],降低血肿发生率[OR=0.28,95%CI(0.09,0.88),1=0.03],减少导管使用数量[OR=-1.00,95%CI(-1.81,-0.19),P=0.02]。结论与触诊相比,超声引导在成人桡动脉穿刺中可显著提高首次穿刺成功率、降低血肿发生率、减少导管使用数量。

Objective To systematically evaluate the effect of ultrasound-guided technique in radial artery puncture in adults.Methods Randomized controlled trials on ultrasound guided and palpation in adult radial artery puncture were searched in CNKI,Wanfang,VIP,SinoMed,PubMed,CINAHL,Cochrane Library,Web of Science,Embase,and database of clinical trials.RevMan 5.0 software was used for performing a Meta-analysis.Results Totally 11 studies involving 2284 participants were enrolled.Results of this meta-analysis suggested that ultrasound guided technique can improve the success rate of the first puncture in adult radial artery puncture,[OR=3.89,95%CI(2.52,6.01),P<0.001],reduce the average number of puncture[MD=-0.98,95%CI(-1.73,-0.23),P=0.01],reduce the incidence of hematoma[OR=0.28,95%CI(0.09,0.88),P=0.03],reduce the number of catheters used[OR=-1.00,95%CI(-1.81,-0.19),P=0.02].Conclusion Current evidence indicates that ultrasound-guided radial artery puncture in adults could significantly increase the first success rate,reduce the incidence of hematoma and the number of catheters used.