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

发布时间：2018-03-08 08:55

本文选题：静脉血栓形成　切入点：导管插入术　出处：《临床荟萃》2017年02期 　论文类型：期刊论文

【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,P0.01),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,P0.01;重症监护:OR=3.954,95%CI=2.181~7.168,P0.01)。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。
[Abstract]:Objective to compare the risk of venous thrombosis associated with central inserted central catheterization via peripheral venous puncture and central venous catheterization (CVCs). Methods the PubMed database was searched for Cochrane clinical trials. CNKI, Chinese Biomedical Literature Database (CBM) and Wanfang database were used to find out the clinical controlled studies on the risk of venous thrombosis associated with PICCs and CVCs. A meta-analysis of 6 299 patients in 17 studies showed that compared with CVCs, the risk of venous thrombosis in patients with malignant tumor and in intensive care was significantly higher than that in patients with malignant tumor and intensive care, and the risk of venous thrombosis in patients with malignant neoplasms and intensive care was significantly higher than that in patients with malignant tumor and severe care (malignant tumor). The results of meta analysis showed that the risk of venous thrombosis in patients with malignant tumor and intensive care was significantly higher than that in patients with CVCs. The number of patients in need of treatment was 1.949 / 4.770 / P0.01. the number of patients in need of treatment was 2.181 / 7.168. no significant bias was found in funnel and Egg tests. Conclusion the risk of venous thrombosis associated with PICCs is higher than that of CVCs, especially in patients with malignant tumor and intensive care.
【作者单位】：玉溪市人民医院骨外二科;邯郸市中医院急诊科;玉溪市人民医院科教科;玉溪市人民医院重症医学科;
【分类号】：R472.9

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