Meta分析在老年静脉留置针两种封管液效果比较中的应用.docVIP

Meta分析在老年静脉留置针两种封管液效果比较中的应用 李善玲1 ，杨新丽 关键词：Meta分析；老年；静脉留置针；肝素钠封管；生理盐水封管 Meta-Analysis in Comparison of the Effects of two kinds of Sealed Solution for Old Venous Indwelling Needle//Li shanling，yang xinli (People,s Hospital of liyuan,Tongji Medical College,Huazhong University of Science and Technolgy,Wuhan 430000 ,China) Abstract: Objective To evaluate the effects of two kinds of sealed solution for old venous indwelling needle. Methods A comprehensive, systematic bibliographic search of medical literature from databases of CNKI ,Weipu and Wanfang was conducted to identify randomized controlled trials(RCTs) related to catheter sealing with saline vs. heparin. The remaining time of venous needle, the incidence of phlebitis and the catheter blockage were compared, and the quality of RCTs was assessed and meta-analyses were conducted by RevMan 4.2.10 sotfware. Results Ten RCTs involving 1126 patients were included. The results of meta-analyses showed that: The aver-age remaining time of venous catheter between saline sealing and heparin sealing; There was no signifi cant difference between saline sealing and heparin sealing in the catheter blockage and incidence of phlebitis. Conclusion The meta-analyses of cur-rent medical literature show that heparin sealing can prolong the remaining time of catheter, although there is no significant effect in the aspect of the incidence of catheter blockage and phlebitis. Key Words: Meta-analysis;Old;Venous remaining needle;Heparin sodium sealing;Saline sealing 静脉留置针又称套管针, 已于三十年代在欧美国家普及使用, 十年前在亚洲一些较发达国家和地区也广泛使用[1]。老年病人有皮肤老化、皱纹增加、皮下组织疏松及血管弹性降低、血管壁薄的特点，静脉穿刺难度大，给老年病科护理人员在静脉穿刺中增加了工作量。静脉留置针的应用，减轻了护理人员的工作量，减轻了患者的痛苦，保护了老年病人的血管，保证了治疗、抢救的顺利进行。静脉留置针封管是留置针有效应用的重要环节，如方法得当可延长留置时间，防止并发症的发生，方法不当可致局部血栓形成，造成堵管而诱发浅表静 脉炎或渗漏。因此，静脉留置针封管液在老年病人，尤其在住院时间长、反复发病、危重患者中如何应用已成为护理工作的一个重要问题。 目前有关老年人静脉留置针封管液的选择研究已不少，主要侧重于生理盐水和不同浓度肝素钠封管的效果比较，但哪种封管液对老年人静脉留置针封管效果较好，既能延长留置针的留置时间，又能减少阻管，尚无定论。为解决这一问题，为临床老年人封管液的选择提供可靠的证据，我们系统评价了老年人静脉留置针生理盐水封管与肝素钠封管的效果。 1 资料与方