摘要
目的系统评价局部麻醉在超声引导下改良赛丁格技术行经外周静脉置入中心静脉导管术(PICC)中对疼痛、肢体回缩反应、一次穿刺成功率的影响,为PICC置管术前麻醉时机的选择提供循证依据。方法计算机检索Cochrane Controlled Trials Register、PubMed、EMbase、中国生物医学文献数据库、万方数据库、中国期刊全文数据库、中国维普全文数据库,检索时间为建库至2017年11月,收集有关利多卡因在超声引导下辅助改良赛丁格技术PICC中应用的随机及非随机对照试验。采用Jadad量表对纳入文献进行质量评价,提取有效数据后采用Rev Man 5.3软件进行Meta分析。结果共纳入7篇文献,Meta分析结果显示:穿刺前进行局部麻醉与传统局部麻醉对患者疼痛次数、疼痛程度、肌肉收缩反应及一次穿刺成功率的影响存在统计学差异,观察组优于传统局麻组。结论与传统扩皮前局麻相比,穿刺前进行局部麻醉可减少PICC置管患者的疼痛次数,减轻疼痛程度,减少肌肉收缩反应,提高一次穿刺成功率。
Objective To systematically evaluate the effects of local anesthesia on pain,limb retracting reaction and one success rate of puncture during ultrasound guided insertion of peripherally inserted central catheters by using improved Sedinger technique,and to provide evidence for the anesthesia opportunity of PICC catheterization.Methods A computerized search in Cochrane Library,PubMed,EMBASE,CBM data,Wanfang data,CNKI,VIP data was performed to find out relevant randomized controlled trials(RCTS)and Non randomized controlled trials(NRCTS)which concern ultrasound guided peripherally inserted central catheter(PICC)insertion.The Jadad scale was used to evaluate the quality of the included studies.Data were analyzed by Rev Man 5.3 version.Results Seven studies were included,and meta-analysis showed that there were significant differences in the effects of local anesthesia before puncture and traditional local anesthesia on the number of pain,the degree of pain,muscle contraction reaction and the success rate of one puncture.The observation group was superior to the traditional local anesthesia group.Conclusions Local anesthesia prior to the insertion of peripherally inserted central catheters could reduce the pain and limb retracting reaction,and improve the success rate of one time puncture.
作者
石丽梅
傅桂芬
李丽蓉
梁娟
王婷
班志新
SHI Li-mei(Radiotherapy ward,the people's hospital of Guangxi Zhuang Autonmous Region,Nanning,Guangxi,530021,China)
出处
《齐齐哈尔医学院学报》
2019年第15期1856-1860,共5页
Journal of Qiqihar Medical University
基金
广西壮族自治区卫生和计划生育委员会自筹经费科研课题(Z2016642,Z2015338)
关键词
PICC
局部麻醉
效应分析
Peripherally insert central catheter
Local anesthesia
Effect analysis
作者简介
通信作者:傅桂芬,Email:shilimei121314@163.com
