[1]黄 娟,龚放华,马文婷,等.单纯枸橼酸钠与肝素在成人血液透析长期导管封管效果比较的Meta分析[J].医学信息,2022,35(18):25-29,38.[doi:10.3969/j.issn.1006-1959.2022.18.006]
　HUANG Juan,GONG Fang-hua,MA Wen-ting,et al.Meta-analysis of Long-term Catheter Sealing Effect Between Sodium Citrate Alone and Heparin in Adult Hemodialysis Patients[J].Journal of Medical Information,2022,35(18):25-29,38.[doi:10.3969/j.issn.1006-1959.2022.18.006]
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单纯枸橼酸钠与肝素在成人血液透析长期导管封管效果比较的Meta分析()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
35卷
期数:
2022年18期
页码:
25-29,38
栏目:
论著
出版日期:
2022-09-15

文章信息/Info

Title:
Meta-analysis of Long-term Catheter Sealing Effect Between Sodium Citrate Alone and Heparin in Adult Hemodialysis Patients
文章编号:
1006-1959（2022）18-0025-06
作者:
黄 娟; 龚放华; 马文婷; 等
（湖南省人民医院血液净化二部，湖南 长沙 410005）
Author(s):
HUANG Juan; GONG Fang-hua; MA Wen-ting; et al.
(The Second Department of Blood Purification,Hunan Provincial People’s Hospital,Changsha 410005,Hunan,China)
关键词:
枸橼酸;  肝素; 血液透析; 封管
Keywords:
Citric acid; Heparin; Hemodialysis; Tube sealing
分类号:
R473.5
DOI:
10.3969/j.issn.1006-1959.2022.18.006
文献标志码:
A
摘要:
目的 用Meta分析的方法比较单纯枸橼酸钠和肝素在成人血液透析长期导管封管中的应用效果。方法 检索英文数据库有PubMed、CINAHL、The Cochrane Library；中文数据库有知网、万方、维普。手工检索American Joumal of Kidney Disease Home和《中华肾脏病杂志》，纳入符合标准的随机对照（RCT）试验，检索时限均为建库至2021年8月12日。使用RevMan5.4进行Meta分析。结果 共纳入11个RCT试验，患者总计1259例。其中，实验组682例，对照组631例。Meta分析结果显示：与肝素封管液比较，单纯枸橼酸钠可减少出血风险[RR=0.22，95%CI（0.11~0.45），P＜0.0001]；肝素封管后，凝血功能（活化部分凝血酶原时间APTT）显著延长[RR=-2.06，95%CI（-3.12~-0.99），P=0.0001]；但两组在导管相关性感染的指标上以不同统计单位（病人数、透析次数、导管留置天数）进行亚组分析，差异无统计学意义（P≥0.05）；两者溶栓治疗次数、导管功能障碍所致拔管、导管相关性住院率、全因死亡率比较，差异无统计学意义（P＞0.05）。结论 单纯枸橼酸钠用于成人血液透析长期导管封管，可显著降低出血发生率，且不影响机体凝血功能，作为封管液更安全。
Abstract:
Objective To compare the application effects of sodium citrate and heparin in long-term catheter sealing of adult hemodialysis by Meta-analysis.Methods English databases such as PubMed, CINAHL and The Cochrane Library and Chinese database such as CNKI, Wanfang, VIP were searched, and manually searched the randomized controlled trials that met the inclusion criteria in American Journal of Kidney Disease Home, Chinese Journal of Nephrology.The retrieval time was from the establishment of the database to August 12, 2021. Meta-analysis was performed using RevMan5.4.Results A total of 11 RCTs involving 1259 patients were included. Among them, 682 cases in the experimental group and 631 cases in the control group. The results of Meta-analysis showed that compared with heparin sealing fluid, sodium citrate alone could reduce the risk of bleeding [RR=0.22, 95%CI(0.11-0.45),P<0.0001]. After heparin sealing, coagulation function (activated partial thromboplastin time APTT) was significantly prolonged [RR=-2.06,95%CI(-3.12--0.99),P=0.0001]. However, there was no significant difference between the two groups in the subgroup analysis of catheter-related infection with different statistical units (number of patients, dialysis times, catheter indwelling days)(P≥0.05). There was no significant difference in the number of thrombolytic therapy, extubation caused by catheter dysfunction, catheter-related hospitalization rate and all-cause mortality between the two groups (P>0.05).Conclusion Sodium citrate alone for long-term catheter sealing in adult hemodialysis can significantly reduce the incidence of bleeding without affecting the body ’s coagulation function, and is safer as a sealing fluid.

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更新日期/Last Update: 1900-01-01