皮肤消毒剂预防重症患者血管导管相关感染的网状Meta分析
Prevention of skin antiseptic solutions for intravascular catheter-related infection in intensive care unit:a network Meta-analysis
曹立娟 1杨涛 1刘素霞 1邹秀珍 1陈亚男 1刘菁1
作者信息
- 1. 连云港市第一人民医院,江苏连云港 222006
- 折叠
摘要
目的 评价皮肤消毒剂预防重症患者血管导管相关感染的有效性.方法 计算机检索PubMed、Cochrane Library、中国知网(CNKI)和万方数据库,搜集重症患者置入血管导管前皮肤消毒的随机对照试验(RCT),检索时限均从建库至 2021 年 10 月 8 日,采用Stata 17 和R 4.2 软件进行网状Meta分析.结果 共纳入 8 个RCT,共计 4 990 例患者和 8 749 例导管,涉及 8 种皮肤消毒剂,分别为 0.5%、1%和 2%氯己定醇、2%氯己定水溶液、氯己定混合溶液(0.25%氯己定+0.025%苯扎氯铵+4%苯甲醇,CBB)、10%聚维酮碘、5%聚维酮碘醇和 70%异丙醇.网状Meta分析结果显示,2%氯己定醇的导管病原菌定植发生率低于 5%聚维酮碘醇[OR=0.18,95%CI(0.04～0.89)],概率排序结果为 2%氯己定醇>CBB>2%氯己定水溶液>1%氯己定醇>5%聚维酮碘醇>0.5%氯己定醇>70%异丙醇>10%聚维酮碘.在降低导管相关血流感染方面,8 种皮肤消毒剂之间差异均无统计学意义(P>0.05),概率排序结果为 2%氯己定醇>CBB>1%氯己定醇>2%氯己定水溶液>0.5%氯己定醇>70%异丙醇>5%聚维酮碘醇>10%聚维酮碘.结论 2%氯己定醇在预防重症患者血管导管相关感染效果更优.
Abstract
Objective To systematically review the effect of skin antiseptic solutions for the prevention of intravascular catheter-related infection in critically ill patients.Methods PubMed,Cochrane Library,CNKI and Wanfang Data were searched to collect randomized controlled trials(RCTs)of skin disinfectantsin intensive care units with vascular catheter from inception to October 8th,2022.Statistical analysis was performed by Stata 17 and R 4.2 software.Results A total of 8 RCTs involving 4 990 patients and 8 749 catheters with eight antiseptic agents including 0.5%,1%and 2%CHG-alcohol,2%CHG-aqueous,CHG mixedsolution(0.25%chlorhexidine gluconate,0.025%benzalkonium chloride,and 4%benzylic alcohol,CBB),10%povidone-iodine(PVI),5%PVI-alcohol and 70%isopropyl alcohol were included.The network Meta-analysis showed that 2%CHG-alcohol had a significant reduction in the incidence of catheter colonization compared with 5%PVI-alcohol(OR=0.18,95%CI 0.04-0.89).The probabily rank were 2%CHG-alcohol>CBB>2%CHG-aqueous>1%CHG-alcohol>5%PVI-alcohol>0.5%CHG-alcohol>70%isopropyl alcohol>10%PVI.In reducing the catheter-related bloodstream infections,there was no statistically significant difference among the eight skin disinfectants,and the probabily rank were 2%CHG-alcohol>CBB>1%CHG-alcohol>2%CHG-aqueous>0.5%CHG-alcohol>70%isopropyl alcohol>5%PVI-alcohol>10%PVI.Conclusions 2%CHG-alcohol is a priority choice for the prevention and control of intravascular catheter-related infection in critically ill patients.
关键词
皮肤消毒剂/重症/血管导管相关感染/网状Meta分析Key words
skin disinfectant/critically ill/intravascular catheter-related infection/network Meta-analysis引用本文复制引用
基金项目
江苏省医院协会医院管理专项基金资助项目(JSYGY-1-2021-JZ39)
出版年
2024
NETL
NSTL
万方数据