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经外周静脉穿刺中心静脉置管与其他中心静脉置管相关性静脉血栓的meta分析

  

  1. 1. 玉溪市人民医院 a.骨外二科;b.科教科;c.重症医学科,云南 玉溪 653100; 2.邯郸市中医院 急诊科,河北 邯郸 056001
  • 出版日期:2017-02-05 发布日期:2017-02-08
  • 通讯作者: 通信作者:刘建平,Email:270160748@qq.com

Peripherally inserted central catheters and centralvenous catheters related vein thrombosis: a metaanalysis

  1. 1a.Department of Orthopedic Surgery; 1b.Department of Science and Education;
    1c. Department of Intensive Medicine, Yuxi People's Hospital, Yuxi 653100, China;
    2. Department of Emergency, Handan Hospital of Traditional Chinese Medicine, Handan 056001, China
  • Online:2017-02-05 Published:2017-02-08
  • Contact: Corresponding author: Liu Jianping,Email:270160748@qq.com

摘要: 目的通过系统分析比较经外周静脉穿刺中心静脉置管(peripherally inserted central catheters,PICCs)和其他中心静脉置管(centralvenous catheters,CVCs)相关性静脉血栓发生风险。方法检索PubMed数据库、Cochrane临床试验数据库、中国知网(CNKI)、中国生物医学文献数据库(CBM)和万方数据库,查找PICCs和CVCs相关静脉血栓发生风险的临床对照研究。结果依纳入标准,共包含17个研究,6 299例患者。Meta分析结果显示:与CVCs相比,PICCs置管静脉血栓发生风险升高(OR=2.785,95%CI=1.796~4.321,P<0.01),亚组分析提示恶性肿瘤和重症监护患者静脉血栓发生风险均明显升高(恶性肿瘤:OR=3.049,95%CI=1.949~4.770,P<0.01;重症监护:OR=3.954,95%CI=2.181~7.168,P<0.01)。需治疗人数(NNT)=-30,95%CI=-31.25~-27.78。漏斗图及Egg检验未见明显发表偏倚,敏感性分析显示结果稳定。结论PICCs高于CVCs相关性静脉血栓的发生风险,尤其对恶性肿瘤和重症监护患者,临床应加强PICCs使用者的血栓筛查。

关键词: 静脉血栓形成;导管插入术, 中心静脉;Meta分析

Abstract: ObjectiveTo systematically compare the risk of peripherally inserted central catheters(PICCs) and centralvenous catheters(CVCs) related vein thrombosis. MethodsThe PubMed, the Cochrane Library, CNKI, CBM and Wan fang databases were searched to find literatures evaluating PICCs and CVCs related vein thrombosis. ResultsA total of 17 studies with 6 299 participants were finally included in the metaanalysis. The pooled odd risk for PICCs related vein thrombosis was 2.785(95%CI=1.7964.321,P<0.01). The pooled odd risk for malignant tumor and intensive care were  3.049 (95%CI=1.9494.770,P<0.01)  and 3.954(95%CI=2.1817.168,P<0.01), respectively. NNT=-30, 95%CI=-31.25     -27.78. There were no publication bias,and the outcome was stable by the sensitivity analysis. ConclusionPICCs increased the morbidity of vein thrombosis, especially for malignant tumor and intensive care, so PICCs related vein thrombosis needs more attention in clinic.

Key words: venous thrombosis;catheterization, central venous; metaanalysis