Safety of heparin used in plasma exchange and molecular absorbent recirculating system for hepatic failure:a Meta-analysis
10.3760/cma.j.issn.1672-7088.2018.11.017
- VernacularTitle:肝素用于血浆置换及分子吸附再循环系统治疗肝衰竭安全性的Meta分析
- Author:
Zhenyan DONG
1
;
Danfeng ZHAO
;
Weiyi SU
;
Shuting WEI
Author Information
1. 广西壮族自治区桂东人民医院护理部
- Keywords:
Plasma exchange;
Molecular absorbent recirculating system;
Heparin;
Meta-analysis
- From:
Chinese Journal of Practical Nursing
2018;34(11):874-880
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the safety of heparin used in plasma exchange (PE) and molecular absorbent recirculating system (MARS) for hepatic failure. Methods 8 databases were electronically searched including CNKI,CBM,WANFANG,VIP,PubMed,Web of Science,Cochrane and EMBASE.Two researchers individually performed the literature screening,data extraction and evaluation of risk of bias.Random or fixed effect model based on the result of the test of heterogeneity were chosento synthesize the datausing RevMan 5.3 software. Results 6 eligible studies with 863 patientswere included. Compared to omitting of heparin, the heparin PE could increase the probability of circuit clotting, hemorrhage in puncture point, puncture hematoma (RR = 6.05, 95% CI:2.00-18.30, P=0.001;RR=10.80,95% CI:4.78-24.37,P<0.05;RR=6.34,95% CI:1.13-35.53,P=0.04),but the probability of circuit blocking and other adverse reactions are not influenced(RR=5.61,95% CI:0.99-31.89,P=0.05;RR = 1.17,95% CI: 0.73-1.86, P=0.51). As for the treatment with MARS, heparin could increase the chance bleeding death (RR =12.04, 95% CI:1.69-85.66, P=0.01), but had no obvious effect on circuit clotting. Conclusion When curing the hepatic failure,heparin PE can increase the probability of circuit clotting, hemorrhage in puncture point and puncture hematoma, and heparin MARSE can increase the probability of bleeding death. On the contrary, no-heparin PE and MARSE will be safer in treatment of hepatic failure.
