目的:中心静脉导管(CVC)闭塞的处理仍然没有明确的循证指南。已经进行了比较肝素和生理盐水减少血栓形成的研究,但是证据不足以表明其中一个相对于另一个的显著优势。因此,该研究旨在评估肝素和生理盐水冲洗在预防儿科癌症患者CVC闭塞中的有效性.
方法:在PubMed中进行了全面搜索,WebofScience,科克伦,MEDLINE,CINAHL,Embase,世界卫生组织国际临床试验注册平台,和ClinicalTrials.gov平台使用特定的关键字。搜索一直持续到2022年3月。本研究包括5项随机对照试验。
结论:共有316名儿科癌症患者的5项研究符合纳入标准。由于癌症类型的变化,这些研究被发现是异质的,肝素浓度,CVC的冲洗频率,和用于测量遮挡的方法。尽管存在这些差异,肝素和生理盐水冲洗预防CVC闭塞的效果没有显着差异。分析显示,生理盐水在预防儿科癌症患者的CVC闭塞方面与肝素一样有效。
结论:本系统综述和荟萃分析表明,在儿科癌症患者中,使用肝素和生理盐水冲洗在预防CVC闭塞方面没有显着差异。考虑到肝素的潜在风险,建议使用生理盐水冲洗以防止CVC阻塞.
The management of central venous catheter (CVC) occlusion remains an area without clear evidence-based guidelines. Studies have been conducted that compare the use of heparin and normal saline for reducing thrombosis, but the evidence is not strong enough to suggest a significant advantage of one over the other. Therefore, the study aimed to assess the effectiveness of heparin and normal saline flushing in preventing CVC occlusion in pediatric patients with cancer.
A comprehensive search was conducted in PubMed, Web of Science, Cochrane, MEDLINE, CINAHL, Embase, World Health Organization International Clinical Trials Registry Platform, and ClinicalTrials.gov platform using specific keywords. The search was conducted until March 2022. Five randomized controlled trials are included in this study.
Five studies with a total of 316 pediatric cancer patients met the inclusion criteria. The studies were found to be heterogeneous due to variations in the types of cancer, heparin concentration, flushing frequency of CVCs, and methods used to measure occlusion. Despite these differences, there was no significant difference in the effect of flushing with heparin and normal saline in preventing CVC occlusion. The analysis revealed that normal saline is as effective as heparin in preventing CVC occlusion among pediatric cancer patients.
This systematic review and meta-analysis demonstrated that there is no significant difference between the use of heparin and normal saline flushing in preventing CVC occlusion among pediatric cancer patients. Considering the potential risks of heparin, the use of normal saline flushing may be recommended to prevent CVC obstruction.