Comparison Of Efficacy Of Modified Seldinger Technique Guided By Ultrasound And Traditional Method For Peripherally Inserted Central Catheter: A Meta-analysis

ObjectiveTo systemically evaluate the clinical efficacy between ultrasound-guided modifiedSeldinger technique and traditional method for peripherally inserted central catheter inpatient with long-term infusion with meta-analysis.MethodsAccording to the method of evidence-based medicine, constructed the clinicalproblem with the PICO principle, used the online search engines to search original studiespublished about the clinical efficacy of ultrasound guided modified Seldinger techniqueversus traditional method for peripherally inserted central catheter that were included inPubmed, Medline, Elsevier-SDOL, The Cochrane Library, CNKI, VIP, Wanfang databasesfrom2001to2011. According to the inclusion and exclusion criteria,8literatures wereenrolled. The quality of these included literatures was evaluated, then according todifferent technique these studies were divided into two groups. After2reviewersextracted the relevant data respectively，Meta-analysis of data extracted by using RevMan5.1software was performed.ResultsA total of8literatures that meet the requirements were enrolled, including6randomized controlled trials (RCT) and2quasi-randomized controlled trials (Quasi-RCT),total876cases, including455patients in the ultrasound-guided modified Seldingertechnique group and421patients in the traditional method group. Meta-analysis resultsshowed: Compared to the traditional method group, ultrasound-guided modified Seldingertechnique group had higher success rate of first puncture(RR=1.22,95%CI1.14to1.30,P<0.00001); higher success rate of first catheter placement (RR=1.13,95%CI1.08to1.18,P<0.00001); less incidence rate of mechanical phlebitis after catheterization (RR=0.06,95%CI0.02to0.17, P<0.00001); less incidence rate of vein thrombosis aftercatheterization (RR=0.09,95%CI0.02to0.50, P=0.005); less incidence rate of puncturesite bleeding after catheterization (RR=0.14,95%CI0.02to0.88, P=0.04). ConclusionCompared with traditional method PICC, PICC performed by ultrasound-guidedmodified Seldinger technique has the advantages of higher success rate of first puncture,higher success rate of first catheter placement, lower complications rate of mechanicalphlebitis、vein thrombosis and puncture site bleeding after catheterization.