肿瘤患者应用植入式静脉输液港与中心静脉置管效果的Meta分析  

Application of implantable venous access port and peripherally inserted central cathetering to the treatment of malignant tumors: a Meta-analysis

作　　者：王今[1] 梁琳[1] 熊壮[2] 蒋俊[1] 

机构地区：[1]安徽医科大学第一附属医院肿瘤放疗科,安徽合肥230022 [2]安徽医科大学第一附属医院介入科,安徽合肥230022

出　　处：《中华疾病控制杂志》2015年第11期1158-1161,1173,共5页Chinese Journal of Disease Control & Prevention

基　　金：安徽省教育厅自然科学重点项目(KJ2010A170)

摘　　要：目的运用Meta分析的方法评价国内植入式静脉输液港（venous access port，VAP）与外周深静脉穿刺中心静脉置管（peripherally inserted central catheter，PICC）技术在恶性肿瘤患者应用中的穿刺成功率、导管留置时间≥1年的患者比例以及并发症的发生率。方法搜索CBM、CNKI、万方及维普数据库，纳入有关植入式静脉输液港技术和中心静脉置管术的随机对照研究（randomized controlled studies，RCT）。采用Jadad评分评价研究质量，运用STATA12．0软件对相关数据进行Meta分析。结果本研究共纳入11篇RCT，包括1016例患者。Meta分析结果显示：采用VAP的患者一次穿刺成功率和采用PICC的患者相近（OR=I．172，95％凹：0．643—2．138，P=0．604）；采用VAP的患者导管留置时间≥1年的比例要高于采用PICC的患者（OR=40．045，95％C／：18．349～87．396，P〈0．001）。采用VAP患者的并发症发生率低于采用PICC的患者（出血和感染等并发症：OR=0．141，95％CI：O．084—0．238，P〈0．001；导管相关并发症：OR：0．204，95％C／：0．117～0．355，P〈0．001）。结论现有的研究表明，在恶性肿瘤治疗过程中采用植入式静脉输液港效果要优于中心静脉置管，植入性静脉输液港导管留置时间更长，不良反应的发生率更低，值得临床推广。Objective To evaluate the success rate of puncture, duration of cathetering indwelling for more than one year and complications of the implantable venous access port （VAP） technology and peripherally inserted central cathe- ter （PICC） for patients with malignant tumors. Methods Randomized controlled studies （RCTs） of the implantable ve- nous port technology and central venous cathetering were retrieved from CBM, CNKI, Wanfang and VIP databases. The quality of studies was evaluated by Jadad score. STATA 12.0 software was used to conduct this meta-analysis . Results Eleven RCTs involving 1 016 patients were identified in the study. The results showed that the one-time success rate of puncture in the group of using VAP technology was similar with the group of using PICC （OR = 1. 172,95% CI： 0. 643- 2. 138, P = 0. 604）. The duration of cathetering indwelling for more than one year in the group of using VAP technology was longer than the group using PICC （OR = 40. 045,95% CI：18. 349-87. 396,P 〈 0. 001 ）. The incidence of complications in the group of using VAP technology was lower than the group using PICC （bleeding and infection： OR = 0. 141,95% CI： 0. 084-0. 238,P 〈 0. 001 ;complications of cathetering： OR = 0. 204,95% CI：0. 117-0. 355, P 〈 0. 001 ）. Conclusions The VAP technology is better than PICC. The duration of cathetering indwelling is longer and the incidence of complications is lower. The VAP technology is worth to be promoted in clinical practice.

关 键 词：导管插入术 中心静脉 穿刺术 手术后并发症 META分析 

分 类 号：R181[医药卫生—流行病学]