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国家卫生健康委员会
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英文作者:Zhong Xuehong1 Wang Jingjing1 Wu Xuhong2 Wang Juan1
单位:1国家儿童医学中心首都医科大学附属北京儿童医院新生儿重症监护室,北京100045;2国家儿童医学中心首都医科大学附属北京儿童医院护理部,北京100045
英文单位:1Intensive Care Unit National Center for Children′s Health China Beijing Children′s Hospital Capital Medical University Beijing 100045 China; 2Nursing Department National Center for Children′s Health China Beijing Children′s Hospital Capital Medical University Beijing 100045 China
关键词:静脉血栓;新生儿;经外周置入中心静脉导管;Meta分析
英文关键词:Venousthrombosis;Neonates;Peripherallyinsertedcentralcatheter;Meta-analysis
目的 系统评价新生儿经外周置入中心静脉导管(PICC)相关性血栓的发生率。方法 计算机检索Medline、Embase、Web of Science、CINAHL、中国生物医学文献数据库、中国期刊全文数据库、维普中文科技期刊数据库和万方数据库中与新生儿PICC相关性血栓发生率相关的研究,检索时限为建库至2022年5月17日。双人进行筛选、质量评价后,采用Stata 16.0软件进行Meta分析。结果 共纳入5项研究,总样本量为4 573例,其中共发生104例PICC相关性血栓。Meta分析结果显示新生儿PICC相关性血栓的发生率为1.7%(95%置信区间:0.5%~3.6%)。亚组分析结果显示,发表年份为2017—2021年的文献、经下肢静脉置管的新生儿PICC相关性血栓的发生率更高。结论 新生儿PICC相关性血栓的发生率为1.68%。经下肢静脉置管时,血栓的发生率更高,因此对于凝血功能障碍、血栓发生风险高的新生儿,应尽量避免选择经下肢静脉置管。
Objective To systematically evaluate the incidence of peripherally inserted central catheter(PICC)-related thrombosis in neonates. Methods Medline, Embase, Web of Science, CINAHL, China Biology Medicine Disc, China National Knowledge Infrastructure, VIP Database and Wanfang Database were searched for studies on the incidence of PICC-related thrombosis in neonates by computers. The search time limit was from the establishment of the database to May 17, 2022. After screening and quality evaluation by two reviewers, Meta-analysis was performed using Stata 16.0 software. Results A total of 5 studies were included, with a total sample size of 4 573 cases, among which 104 cases of PICC-related thrombosis occurred. Meta-analysis showed that the incidence of PICC-related thrombosis in neonates was 1.7%(95% confidence interval: 0.5%-3.6%). The results of subgroup analysis showed that the incidence of PICC-related thrombosis in neonates published from 2017 to 2021 and those with catheterization through the lower extremity vein was higher. Conclusion The incidence of PICC-related thrombosis in neonates is 1.68%. The incidence of thrombosis is higher in neonates with lower extremity venous catheterization. Therefore, for neonates with coagulopathy and high risk of thrombosis, lower extremity venous catheterization should be avoided.
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