| 王芳,彭薇,孔凌,王珂,樊蓉,吕桂兰.肝素与尿激酶联合封管应用于血液透析患者中心静脉导管效果的meta分析[J].上海护理,2021,21(4): |
| 肝素与尿激酶联合封管应用于血液透析患者中心静脉导管效果的meta分析 |
| Meta analysis of the effect of combined application of heparin and urokinase in hemodialysis central venous catheter sealing |
| DOI： |
| 中文关键词: 肝素 尿激酶 血液透析 中心静脉导管 封管 meta分析 |
| 英文关键词:Heparin Urokinase Hemodialysis Central venous catheter Locking Meta-analysis |
| 基金项目:军队医学科技青年培育项目（19QNP076） |
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| 中文摘要: |
| [目的]评价肝素与尿激酶联合应用于血液透析中心静脉导管封管的有效性及安全性。 [方法]检索万方、知网、PubMed、OVID、Cochrane Library、EMBASE、MEDLINE，时间跨度为从建库伊始直至 2020 年 6月。筛选比较肝素（Heparin,HP）联合尿激酶（Urokinase,UK）封管与肝素封管效果的随机对照试验，根据纳、排标准筛选文献，进行质量评价并提取数据后使用RevMan5.3分析。 [结果] 总计纳入8个随机对照试验，统计涉及样本总量为610。HP&UK组相较HP组更能促进导管相关性感染率下降 [RR=0.20 , 95%CI（0.09，0.45），P=0.0001]；提高透析充分性[MD=0.38 , 95%CI（0.08 ，0.70）, P＜0.00001]；提高透析血流量[MD=51.13 , 95%CI（28.97 ，73.29）, P＜0.00001]；导管功能障碍发生率下降 [RR=0.19 , 95%CI（0.08,0.46）, P=0.0002]；二组之间出血率的差异无统计学意义[RR=0.77 , 95%CI（0.48 ，1.25）, P=0.30]。 [结论] 肝素联合尿激酶应用于血液透析中心静脉导管有助于减低导管感染率，并对提高通畅性能够产生积极影响，且不增加出血的风险。 |
| 英文摘要: |
| Objective：To evaluate the efficacy and safety of heparin combined with urokinase in hemodialysis central venous catheter sealing.. Methods:Search Wanfang, CNKI, PubMed, OVID, Cochrane Library, EMBASE, MEDLINE, the time span is from the beginning of construction to June 2020. Screening of a randomized controlled trial comparing the effect of Heparin (HP) combined with Urokinase (UK) tube sealing with Heparin. The literature was screened according to the inclusion and exclusion criteria, after quality evaluation and data extraction, RevMan5.3 was used for analysis. Results:A total of 8 randomized controlled trials were included and the total number of samples involved was 610. Compared with the HP group, the HP&UK group reduced the incidence of catheter related infection [RR=0.20, 95%CI (0.09, 0.45), P=0.0001]; Improve dialysis adequacy [MD=0.38, 95%CI (0.08, 0.70), P < 0.00001]; Increase of dialysis blood flow [MD=51.13, 95%CI (28.97, 73.29), P < 0.00001]; Decrease of functional failure rate[RR=0.19, 95%CI (0.08,0.46), P=0.0002]; No significant difference between the two groups in bleeding rates [RR=0.77, 95%CI (0.48, 1.25), P=0.30].Conclusion: The application of heparin combined with urokinase in hemodialysis central venous catheters helps to reduce catheter infection and has a positive effect on improving patency without increasing the risk of bleeding. |
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