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中心静脉导管敷料:一项系统评价

Central venous catheter dressings: a systematic review.

作者信息

Gillies Donna, O'Riordan Elizabeth, Carr Debbie, O'Brien Ida, Frost Judy, Gunning Robbie

机构信息

Research Development Unit, School of Nursing, Family and Community Health, University of Western Sydney, Paranatta Campus, Building ER, Penrith South DC, New South Wales 1797, Australia.

出版信息

J Adv Nurs. 2003 Dec;44(6):623-32. doi: 10.1046/j.0309-2402.2003.02852.x.

Abstract

BACKGROUND

Gauze and tape or transparent polyurethane film dressings such as Tegaderm, Opsite or Opsite IV3000 are the most common types of dressing used to secure central venous catheters (CVCs). Currently, there are no clear guidelines as to which type of dressing is the most appropriate.

AIMS

To identify whether there are any differences between gauze and tape and/or transparent polyurethane film dressings in the incidence of CVC-related infection, catheter-related sepsis, catheter security, tolerance to dressing material, dressing condition and ease of application in hospitalized patients.

METHODS

The Cochrane Controlled Trials Register and Medline, Embase and CancerLit databases were searched to identify any controlled trials comparing the effects of gauze and tape and/or transparent polyurethane dressings on CVCs. Additional references were sought from published and non-published literature. Twenty-three studies were reviewed. Data were extracted independently from each paper by two members of the review team and results compared. Differences were resolved either by consensus or referral to a third person. Authors were contacted for missing information.

RESULTS

Of the 23 studies reviewed, 15 were excluded. Of the remaining eight, data were available for meta-analysis from six studies. Of the six included studies, two compared gauze and tape with Opsite IV3000, two compared Opsite with Opsite IV3000, one compared Tegaderm with Opsite IV3000, and one compared Tegaderm with Opsite.

CONCLUSIONS

There was no evidence of any difference in the incidence of infectious complications between any of the dressing types compared in this review. Each of these comparisons was based on no more than two studies and all of these studies reported data from a small patient sample. Therefore it is unlikely that any of these comparisons would have had sufficient power to detect any differences between groups.

摘要

背景

纱布和胶带或透明聚氨酯薄膜敷料(如泰德 Derm、Opsite 或 Opsite IV3000)是用于固定中心静脉导管(CVC)的最常见敷料类型。目前,对于哪种类型的敷料最合适尚无明确指南。

目的

确定在住院患者中,纱布和胶带及/或透明聚氨酯薄膜敷料在 CVC 相关感染、导管相关脓毒症、导管固定、对敷料材料的耐受性、敷料状况及应用便利性方面是否存在差异。

方法

检索考克兰对照试验注册库、Medline、Embase 和 CancerLit 数据库,以识别比较纱布和胶带及/或透明聚氨酯敷料对 CVC 影响的任何对照试验。从已发表和未发表的文献中寻找其他参考文献。对 23 项研究进行了综述。数据由综述团队的两名成员独立从每篇论文中提取,并比较结果。差异通过共识解决或转交给第三人。联系作者获取缺失信息。

结果

在所综述的 23 项研究中,排除了 15 项。其余 8 项中,有 6 项研究的数据可用于荟萃分析。在纳入的 6 项研究中,2 项比较了纱布和胶带与 Opsite IV3000,2 项比较了 Opsite 与 Opsite IV3000,1 项比较了泰德 Derm 与 Opsite IV3000,1 项比较了泰德 Derm 与 Opsite。

结论

本综述中比较的任何敷料类型在感染并发症发生率方面均无差异证据。这些比较中的每一项都基于不超过两项研究,且所有这些研究报告的都是来自小样本患者的数据。因此,这些比较中的任何一项都不太可能有足够的效力检测出组间差异。

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