Comparation Of Effects And Complications Between Modified Seldinger Technique Guided With Ultrasound And Traditional Method For Peripherally Inserted Central Catheter In China:A Meta-analysis

1. ObjectiveBy the Meta-analysis to talk about the differences in the success rate of the only one-time puncture and PICC intubation, and the complication rate such as phlebitis, thrombosis, duct abnormalities, location of soft tissue injury, infection, catheter comfort and so on.2.MethodsRelevant Chinese literatures published from1995to2014, March were searched in CNKI full-text database, WanFang full-text database, the Chinese biomedical literature database by using the subject headings or key words of "PICC, peripherally inserted central catheter, peripherally inserted central venous catheter, ultrasound, B ultrasound, modified Seldinger technique, complication" and so on. A strict inclusion criteria of the literature searching was performed in accordance with the exclusion criteria, and23literatures met the inclusion criteria. After using the Jadad scale randomized controlled trials to evaluate the relevant criteria of the searching results by two researchers, the literatures were extracted, and finally Stata9.0statistical software for data analysis was adopted.3.Results23eligible studies were incorporated and the results of Meta-analysis showed that the success rate of one-time puncture and PICC intubation in modified Seldinger technique guided with ultrasound was higher than the traditional method for PICC, and the difference was statistically significant(OR=4.58,95%CI=2.53-8.29; OR=5.0695%CI=2.53-8.29). And there were statistically significant differences(OR=0.13,95%CI=0.09-0.19; OR=0.17,95%CI=0.07-0.40; OR=0.13,95%CI=0.07-0.22; OR=0.30,95%CI=0.17-0.53; OR=0.16,95%CI=0.06-0.38) in complication such as phlebitis, thrombosis, duct abnormalities, location of soft tissue injury, infection and so on. When it comes to catheter comfort, the modified Seldinger technique guided with ultrasound was superior to the traditional method for PICC (OR=0.13,95%CI=0.09-0.19)4. Conclusion(1)The success rate of one-time puncture and PICC intubation in modified Seldinger technique guided with ultrasound was significantly higher than traditional method for PICC. The complication rate including such as phlebitis, thrombosis, duct abnormalities, bleeding puncture site, infection in modified Seldinger technique guided with ultrasound were significantly lower than the traditional method for PICC. Catheter comfort was significantly higher than the traditional method for PICC.(2) Elderly who need long-term intravenous infusion, Oncology, hematology and so many hospitalized patients receiving chemotherapy for the first time, Cachexia patients, modified Seldinger technique guided with ultrasound for PICC is recommended.