摘要
目的对国内外PICC置管体外测量方法的研究进行系统评价,分析并评鉴文献中报道的PICC体外测量方法的实施内容、可行性及其效果。方法运用循证护理的方法学,制定PICOD原则,检索Cochrane图书馆、JBI循证卫生保健国际合作中心图书馆、EMbase、Elsevier、Web of Knowledge、Ovid、CBM、CNKI和万方数据库中关于PICC置管体外测量方法的随机对照试验、半随机对照试验和临床对照试验文献。由2位研究者对文献质量进行严格评价和资料提取。结果共纳入文献7篇,均为中文文献,由于各研究间的干预措施异质性较大,故未进行Meta分析,而是对纳入的研究进行描述性分析。7条文献报道了6种改良测量方法,各研究的评价指标和结果差异性较大。结论国外文献提示有关PICC置管体外测量在指南中已有认证的方法,但中文文献的研究显示有多种改良的测量方法,干预措施间的差异性较大,这与研究者PICC导管头端最佳位置的标准不一致有关。因此,国内研究者及PICC置管实践操作者对导管头端最佳位置的标准亟待统一,以便更准确地预估PICC体外测量的长度。
Objective To evaluate the domestic and overseas studies exploring external measurement methods of PICC tip location, and to analyze and assess the implementation, feasibility and effect of the reported measurement methods. Methods Evidence-based nursing methodology was used to establish a PICOD-based question. Randomized controlled trials, quasi-randomized controlled trials and clinical controlled trials on external measurement methods of PICC were searched in Cochrane Library, JBI Library, EM- base, Elsevier, Web of Knowledge, Ovid, CBM, CNKI and Wanfang Data. Quality of studies was evaluated and data were extrac- ted by two researchers. Results Seven studies written in Chinese were included. Meta-analysis was not conducted due to huge heterogeneity in interventions of the included studies. Descriptive analysis was conducted instead. The 7 studies reported 6 modi lied external measurement methods, and the effect measures and outcomes of the studies were quite different. Conclusion Overseas studies showed that external measurement of PICC had been confirmed in clinical practice guidelines. But Chinese studies demon- strated that there were muhiple modified methods, and there were huge differences among interventions which were associated with different criteria of best points for PICC tip termination. Therefore, domestic researchers and PICC practitioners need to reach a consensus in criteria of best points for tip termination, in order to better predict the length of external portion of PICC.
基金
复旦大学护理科研基金资助项目(FNF201012)
关键词
PICC置管
PICC体外测量
导管异位
系统评价
PICC placement
external measurement methods of PICC
catheter malplacement
systematic review
作者简介
张晓菊：女，博士在读，主管护师通信作者：胡雁，huyan@fudan．edu．cn
