护理学报2017，Vol.24Issue(10)：17-26,10.DOI:10.16460/j.issn1008-9969.2017.10.017
间歇充气加压联合低分子肝素预防静脉血栓栓塞症效果的系统评价和试验序贯分析
Effects of Intermittent Pneumatic Compression Combined with Low Molecular Weight Heparin on Prevention of Deep Venous Thrombosis:A Meta-analysis with Trial Sequential Analysis
摘要
Abstract
Objective To systematically assess the effects of intermittent pneumatic compression combined with low molecular weight heparin on the prevention of deep venous thrombosis in inpatients. Methods A computerized search in PubMed, EMBASE, Web of Science, CENTRAL, CNKI, WanFang and VIP was performed for relevant randomized trials (RCTs) focusing the effects of intermittent pneumatic compression combined with low molecular weight heparin on the prevention of deep venous thrombosis in inpatients. Methodological quality of all eligible studies was assessed accordingly by two independent investigators. Then, meta-analysis and trial sequential analysis were performed by using RevMan 5.3 and TSA software, respectively. Results Totally 23 RCTs including 5,257 participants were concluded into the Meta-analysis. Meta-analysis results suggested that when compared to routine nursing, low molecular weight heparin or intermittent pneumatic compression, intermittent pneumatic compression combined with low molecular weight heparin was conducive to reducing the incidence rates of deep venous thrombosis (RR=0.16,95%CI:0.06~0.41,P<0.001),(RR=0.32, 95%CI:0.22~0.46, P<0.001),(RR=0.37, 95%CI:0.25~0.53, P<0.001)and pulmonary embolism(RR=0.16, 95%CI:0.06~0.47,P<0.001), but it may increase the incidence of adverse reactions such as bleeding (RR=5.97, 95%CI:1.75~20.40, P=0.004). Intermittent pneumatic compression combined with low molecular weight heparin, when compared with use low molecular weight heparin alone, did not reduce the incidence of PE (RR=0.72, 95%CI:0.16~3.18, P=0.67). Meanwhile, sensitivity analysis and TSA confirmed the robustness of all pooled results. Conclusion Intermittent pneumatic compression combined with low molecular weight heparin is effective for preventing deep venous thrombosis and pulmonary embolism in inpatients, and could be promoted clinically, but the occurrence of complications such as bleeding should be noted.关键词
间歇加压充气/低分子肝素/静脉血栓栓塞症/Meta分析/试验序贯分析Key words
intermittent pneumatic compression/low molecular weight heparin/venous thrombus embolism/Meta-analysis/trials sequential analysis分类
医药卫生引用本文复制引用
张丽,王莹,于子荞,陈志强,李培培..间歇充气加压联合低分子肝素预防静脉血栓栓塞症效果的系统评价和试验序贯分析[J].护理学报,2017,24(10):17-26,10.基金项目
2011年国家临床重点专科建设项目(2011873) （2011873）
