Objective To assess the effect of atrial electrogram on PICC catheter tip location. Methods We collected randomized controlled trials (RCTs) on locating the PICC catheter tip with atrial electrogram from CNKI, CBM, Wanfang Data, VIP Database, Cochrane Library, JBI Library, PubMed, Ovid, Springer, Web of science and MEDLINE database. Retrieval time for literatures was from the establishment of the database to November 20, 2016. Two researchers worked independently to select the literature and make quality assessment, then Meta analysis was conducted with RevMan 5.2. Results Sixteen RCTs were obtained. Meta analysis results showed that compared with the traditional X ray chest radiograph location, atrial electrogram could increase the accuracy rate of the location of the catheter tip (RR=1.13,95%CI:1.07~1.19,P<0.01)and decrease the incidence rate of related complications (RR=0.41,95%CI:0.30~0.55,P<0.01). Conclusion Atrial electrogram can increase the accuracy rate of the location of the catheter tip and decrease the incidence rate of related complications. Therefore, it is worthy of clinical application.%目的 评价心房内心电图在PICC导管头端定位中的应用效果.方法 计算机检索中国期刊全文数据库、中国生物医学文献服务系统、万方、维普数据库、Cochrane Library、JBI Library、PubMed、Ovid、Springer、Web of Science、Medline数据库,收集应用心房内心电图定位PICC导管头端位置的随机对照试验,数据库检索时限均为建库至2016年11月20日.由2名研究者按照纳入和排除标准独立筛选文献、提取资料和质量评价后,使用RevMan 5.2进行Meta分析.结果 共纳入16项随机对照试验.Meta分析结果显示,心房内心电图定位法较传统X线胸片定位提高了导管头端到位准确率(RR=1.13,95%CI:1.07~1.19,P<0.01);降低了相关并发症的发生率(RR=0.41,95%CI:0.30~0.55,P<0.01).结论 心房内心电图定位可提高导管头端到位准确率且降低了相关并发症的发生率,值得临床推广应用.
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