经外周静脉穿刺中心静脉置管与植入式静脉输液港在化疗患者中应用效果的系统评价

发布时间：2018-11-03 20:18

【摘要】：目的系统评价经外周静脉穿刺中心静脉置管(peripherally inserted central catheter,PICC)与植入式静脉输液港(venous port access,VPA)两种中心静脉置管方式在化疗患者治疗中应用的差异。方法全面检索Cochrane、JBI、PubMed、EMBASE、CINAHL、CBM、维普等数据库,收集所有讨论PICC与VPA对化疗患者应用效果的随机对照试验(randomized controlled trial,RCT)、受控的临床试验(controlled clinical trial,CCT)和队列研究,按照JBI文献评价标准对文献进行质量评价,使用RevMan 5.3进行Meta分析或描述性分析。结果共纳入13篇文献。研究结果显示PICC导管留置时间低于VPA(RR:9.06,95%CI:5.82~14.09);PICC一次性置管成功率高于VPA,但其差别无统计学意义(RR:0.97,95%CI:0.92~1.03),P0.05;PICC并发症发生率大于VPA(RR:0.30,95%CI:0.22~0.41),P0.05;描述性分析显示VPA组生活质量优于PICC组,且留置时间大于1年时,VPA的总费用低于PICC。结论 VPA与PICC相比,并发症发生率低,留置时间长,患者生活质量高,且维护成本相对较低。但由于高质量文献较少,仍需进一步论证研究。
[Abstract]:Objective to evaluate the difference between central venous catheterization (peripherally inserted central catheter,PICC) via peripheral vein puncture and (venous port access,VPA (implantable intravenous infusion port) in chemotherapy patients. Methods We searched the database of Cochrane,JBI,PubMed,EMBASE,CINAHL,CBM, Wiper, collected all the randomized controlled trials (randomized controlled trial,RCT) that discussed the effect of PICC and VPA on chemotherapy patients, and controlled the clinical trial (controlled clinical trial,. CCT) and cohort study, the quality of the literature was evaluated according to the standard of JBI literature evaluation, and the Meta analysis or descriptive analysis was carried out using RevMan 5.3. Results A total of 13 articles were included. The results showed that the indwelling time of PICC catheter was lower than that of VPA (the success rate of RR:9.06,95%CI:5.82~14.09); PICC was higher than that of VPA, but the difference was not significant (RR:0.97,95%CI:0.92~1.03), P 0.05; The incidence of PICC complications was higher than that of VPA (RR:0.30,95%CI:0.22~0.41), P0.05.The descriptive analysis showed that the quality of life of VPA group was better than that of PICC group, and the total cost of VPA was lower than that of PICC. when the retention time was more than one year. Conclusion compared with PICC, VPA has lower incidence of complications, longer retention time, higher quality of life and lower maintenance cost. However, due to the lack of high-quality literature, there is still a need for further demonstration and research.
【作者单位】：第二军医大学护理学院野战护理学教研室;
【分类号】：R453

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