目的 系统评价体表定位、超声及腔内心电图技术在新生儿经外周置入中心静脉导管(peripherally in-serted central catheter，PICC)中的定位效果及安全性。方法 计算机检索 Web of Science、PubMed、Embase、CI-NAHL、Cochrane Library、中国知网、维普数据库、万方数据库和中国生物医学文献数据库，检索体表测量、超声及腔内心电图技术进行PICC辅助置管的随机对照试验文献，检索时限为建库至2023年5月31日。由2名研究者独立筛选文献、提取数据和偏倚风险评价后，采用R 4。2。1软件进行网状meta分析。结果 共纳入29项研究，包含3 829例新生儿。网状meta分析结果显示，尖端定位准确率排序:超声定位＞心电定位＞体表定位;一次性置管成功率排序:超声定位＞心电定位＞体表定位;PICC置管时间排序:超声定位＜心电定位＜体表定位;并发症发生率排序:心电定位＜超声定位＜体表定位。结论 现有证据表明，超声与腔内心电图技术在新生儿PICC辅助置管中均具有较好的定位效果，其中超声定位技术可能更具优势。
Network Meta-analysis of location efficacy and safety of different positioning techniques in PICC placement of neonates
Objective To systematically review the efficacy and safety of body surface measurement,ultrasound,and intracavitary electrocardiogram for positioning the catheter tip in the placement of peripherally inserted central catheter(PICC)in neonates.Methods Web of Science,PubMed,Embase,CINAHL,Cochrane Library,CNKI,VIP database,Wanfang database,and CBM were electronically searched to collect randomized controlled trials(RCT)of body surface measurement,ultrasound and intracavity electrocardiogram positioning the catheter tip in PICC placement,and the search time was from the establishment of database to May 31,2023.After 2 researchers independently screened the literature,extracted data,and assessed the risk of bias,R4.2.1 software was used to perform the network meta-analysis.Results A total of 29 studies involving 3,829 neonates were included.The re-sults of network meta-analysis showed that the order of tip positioning accuracy was:ultrasound＞intracavity elec-trocardiogram＞body surface measurement;The order of one-time success rate was:ultrasound＞intracavity elec-trocardiogram＞body surface measurement;The order of time spent on PICC placement was:ultrasound＜intra-cavity electrocardiogram＜body surface measurement;The order of PICC postoperative complications was:intracav-ity electrocardiogram＜ultrasound＜body surface measurement.Conclusion The current evidence shows that ultra-sound and intracavitary electrocardiogram have good positioning effects in neonatal PICC catheterization,and ultra-sound positioning method may be more advantageous.
ultrasoundintracavitary electrocardiogramperipherally inserted central catheterneonateevidence based nursing
NETL
NSTL
万方数据
