局部枸橼酸抗凝的连续肾脏替代治疗过程中管路采血可行性的Meta分析

Feasibility of pipeline blood sampling in continuous renal replacement therapy using regional citrate anticoagulation:a Meta-analysis

目的系统评价行局部枸橼酸抗凝的连续肾脏替代治疗过程中管路采血替代外周血管采血的可行性。方法计算机检索CINAHL、PubMed、Cochrane Library、Embase、中国知网、万方数据知识服务平台、维普中文科技期刊数据库,搜集比较行局部枸橼酸抗凝的连续肾脏替代治疗过程中管路采血和外周血管采血的研究。使用MINORS条目评价纳入研究的偏倚风险,采用RevMan 5.3和Stata 16.0软件进行Meta分析。结果共纳入9个研究,Meta分析结果显示:管路采血在血钙、血钾、血钠、血氯、血糖、血乳酸、剩余碱方面,与外周采血差异没有统计学意义。亚组分析显示,管路采血在酸碱度、二氧化碳分压、碳酸氢根方面,与外周动脉采血组差异有统计学意义。结论行局部枸橼酸抗凝的连续肾脏替代治疗过程中管路采血可以代替外周采血监测患者的电解质指标,但不能代替监测血气分析指标。

Objectives To systematically review the feasibility of pipeline blood sampling instead of peripheral blood vessel sampling in continuous renal replacement therapy using regional citrate anticoagulation.Methods The databases of CINAHL,PubMed,The Cochrane Library,EMbase,CNKI,WanFang Data and VIP databases were searched to collect the related studies.To use the MINORS to evaluate the risk of bias of included studies and the software of RevMan 5.3 and Stata 16.0 was used to do a Meta-analysis.Results Nine studies were included.The meta-analysis showed that there were no significant differences between two groups on Ca^(2+),K^(+),Na^(+),Cl^(-),blood glucose(Glu),Lactic acid(Lac)and Base excess(BE).The subgroup analysis showed that there were significant differences between two blood samplings on PH,PCO_(2),HCO_(3)^(-).Conclusion The current evidences show that pipeline blood sampling can replace peripheral blood vessel sampling to monitor electrolytes,but not blood gas in continuous renal replacement therapy using regional citrate anticoagulation.