The Evidence-based Study Of The External Application Of Hirudoid And Injecting Hyaluronidase In The Treatment Of Extravasation Of Intravenous Infusion In Neonate

Objective:In this study,the evidence-based nursing framework of Joanna Briggs Institute,combined with the Cochrane framework of evidence-based medicine,described and analyzed the treatment of leakage of venous transfusion of Hirudoid and hyaluronidase in current clinical use at home and abroad,and through systematic review of the literature,we summarized the evidence level of Hirudiod and hyaluronidase in the treatment of neonatal venous transfusion leakage,providing evidence to support the application in clinical practice and clinical guidelines.Methods:The retrieval published before June 31,2017 in Cochrane,JBI,MEDLINE,CINAHL,Embase,Proquest,Mednar,CNKI,Wan Fang and VIP database in the randomized or quasi randomized controlled trials of treatment of Hirudoid in intravenous infusion leakage of newborns,quality evaluation and meta-analysis were done with RevMan5.0 software.Collect evidence and judge the level of evidence through systematic evaluation.Taking JBI evidence-based nursing framework,through the retrieval published before June 31,2017 in Cochrane,JBI,MEDLINE,CINAHL,Embase,Proquest,Mednar,CNKI,Wan Fang and VIP database on randomized or quasi randomized controlled trials of treatment hyaluronidase in leakage of venous transfusion in neonates,used JBI SUMARI software to evaluate the quality of them,then descriptive analysis.Collect evidence and judge the level of evidence through systematic review.Results:(1)a total of 15 randomized controlled trials were included in the systematic review of the effect of Hirudoid.The quality is grade B.The meta-analysis including 15 documents was done.The results show:Hirudoid has significant treatment effect of intravenous infusion extravasation compared with Magnesium Sulfate[OR=0.15,95%CI(0.09,0.27)],time of local swelling curing and skin healing is shorter.The 15 studies,according to the Cochrane's 7 items of evaluation criteria for the RCT,had most of the results of "high bias risk"or "unclear".15 literatures belong to the B level.The systematic review of the efficacy of hyaluronidase was included in 2 articles which were quasi experiments.Most of the results of 2 quasi experiments were "no" or "unclear" after the evaluation according to JBI of the evaluation items of quasi experiments.2 literatures belong to the B level.Conclusion:(1)the existing evidence shows that Hirudoid is effective in the treatment of neonatal intravenous infusion leakage,including local swelling and subsiding and skin healing.The evidence for external application of Hirudoid is moderate support and should be used in clinical practice.Due to all the domestic research,lack of support from overseas research,and low quality level,the above conclusions still need more high-quality researches to further verify.(2)The existing evidence shows that hyaluronidase injection is effective in the treatment of leakage of intravenous infusion in newborns,including local skin damage and necrosis alleviated.Hyaluronidase injection should be certain clinical feasibility and clinical significance.The evidence for hyaluronidase injection is moderately supportive and should be used in clinical practice in combination with specific conditions.Many confounding factors may have a certain impact on the research results because of the small number of included studies,low quality and small sample size.The above conclusions need to be further verified by more high quality researches.