PICC置管与外周静脉输注奥沙利铂局部神经毒性反应对比的Meta分析  

Comparison of local neurotoxicity of oxaliplatin between PICC catheterization and peripheral venous infusion:a Meta analysis

作　　者：戈应群 叶容 孙秋艳 周荣森 GE Yingqun;YE Rong;SUN Qiuyan;ZHOU Rongsen(Tumour Institute,the Second Clinical Medical College,Affiliated to Army Medical University,Chongqing 400037 China)

机构地区：[1]陆军军医大学附属第二临床医学院肿瘤研究所,重庆400037 [2]重庆市三峡中心医院 [3]重庆市璧山区农业委员会

出　　处：《护理研究》2020年第2期249-254,共6页Chinese Nursing Research

摘　　要：[目的]对比PICC置管与外周静脉输注奥沙利铂局部神经毒性反应。[方法]检索中文数据库,包括中国生物医学文献数据库、万方数据库、中国知网、维普网;英文数据库,包括PubMed、EMbase、the Cochrane Library,收集PICC置管与外周静脉输注奥沙利铂局部神经毒性反应对比的随机对照试验,检索时间限定为建库至2018年6月30日。采用Cochrane偏倚风险评估工具进行偏倚风险评估。采用RevMan5.3.0进行数据分析。[结果]共纳入12项研究,涉及1069例病人,其中试验组529例,对照组540例。Meta分析结果显示:与外周浅静脉穿刺给药相比,经PICC导管给药能降低神经毒性总体反应发生率[OR=0.12,95%CI(0.09,0.17),P<0.00001]及Ⅰ级、Ⅱ级、Ⅲ级神经毒性反应发生率[OR=0.39,95%CI(0.23,0.66),P=0.0006;OR=0.19,95%CI(0.12,0.30),P<0.00001;OR=0.18,95%CI(0.09,0.36),P<0.00001],但不能降低Ⅳ级神经毒性反应发生率[OR=0.16,95%CI(0.02,1.33),P=0.09]。[结论]现有证据表明:经PICC导管输注奥沙利铂能降低Ⅰ~Ⅲ级局部神经毒性反应发生率。Objective:To compare the local neurotoxic reaction between PICC catheterization and peripheral intravenous infusion of oxaliplatin.Methods:Databases,including PubMed,EMbase,the Cochrane Library,China Biomedical Literature Database,WanFang Database,China Knowledge Network and VIP,were retrieved from the databases establishment to June 30,2018.Relevant randomized controlled trials on comparison of local neurotoxicity between PICC catheterization and peripheral intravenous oxaliplatin infusion were collected.Cochrane bias risk assessment tool was used to take a bias risk assessment.And RevMan 5.3.0 software was used for data analysis.Results:A total of 12 studies were included,involving 1069 patients,529 patients in the experimental group and 540 patients in the control group.Meta-analysis results showed that compared with peripheral superficial venous puncture,PICC catheter administration could reduce overall incidence rate of neurotoxic reactions[OR=0.12,95%CI(0.09,0.17),P<0.00001]and incidence rates of gradeⅠ,Ⅱ,Ⅲneurotoxic reactions[OR=0.39,95%CI(0.23,0.66),P=0.0006;OR=0.19,95%CI(0.12,0.30),P<0.00001;OR=0.18,95%CI(0.09,0.36),P<0.00001].However,PICC catheter administration did not reduce the incidence rate of gradeⅣneurotoxic reactions[OR=0.16,95%CI(0.02,1.33),P=0.09].Conclusion:Current evidence showed that oxaliplatin infusion via PICC catheter could reduce local neurotoxic reactions.

关 键 词：PICC 奥沙利铂 神经毒性反应 META分析 外周静脉 

分 类 号：R47[医药卫生—护理学]