完全植入式输液港与PICC应用效果的系统评价再评价  

Application effect of totally implantable venous access port and PICC:an overview of systematic reviews

作　　者：曹海霞 李必红 赖永明星 彭玉娇 夏琪[1] 温贤秀 Cao Haixia;Li Bihong;Laiyong Mingxing;Peng Yujiao;Xia Qi;Wen Xianxiu(PICC Center,Affiliated Hospital of University of Electronic Science and Technology of China,Chengdu,Sichuan 610000,China;Liangping District Hospital of Traditional Chinese Medicine,Chongqing 405200,China)

机构地区：[1]电子科技大学附属医院·四川省医学科学院PICC中心,四川成都610000 [2]重庆市梁平区中医院,重庆405200

出　　处：《现代临床医学》2022年第3期210-214,共5页Journal of Modern Clinical Medicine

基　　金：2019年度四川省卫生健康科研课题(19PJ120);四川省科技计划项目软科学研究课题(2020JDR0284)。

摘　　要：目的:通过系统评价再评价比较完全植入式输液港(TIVAP)与经外周静脉置入中心静脉导管(PICC)的应用效果。方法:计算机检索Web of Science、CINHAL、PubMed、Cochrane Library、Google学术、CNKI、万方、SinoMed数据库,检索时间从建库至2021年1月,比较PICC与TIVAP应用效果的系统评价/meta分析,采用AMSTAR质量评价工具评价纳入文献的方法学质量,采用循证实践指南研发工具GRADEpro GDT对结局指标进行质量等级评价。结果:最终纳入了8篇系统评价/meta分析,仅3篇为高质量,主要缺陷为未考虑纳入文献的发表状态、检索策略不具有可重复性、未说明相关利益冲突等。对8篇系统评价的10个结局指标进行质量评价,2个结局指标质量等级为低,其余均为极低。结论:纳入的系统评价/meta分析文献整体质量不高,结局指标证据质量主要以极低为主。TIVAP应用效果优于PICC,但误穿动脉及气胸发生率高于PICC。由于证据质量较低,尚需更高质量的研究进一步佐证。Objective:To compare the application effect of totally implantable venous access port(TIVAP)and peripherally inserted central catheter(PICC)through overviewing systematic reviews.Methods:The databases including Web of Science,CINHAL,PubMed,Cochrane Library,Google academic,CNKI,Wanfang and SinoMed were searched by computer from the establishment of the database to January 2021.The systematic review/meta-analysis of the application effects of PICC and TIVAP were compared.AMSTAR quality evaluation tool was used to evaluate the methodological quality of the included literature,and GRADEpro GDT,an evidence-based practice guide development tool,was used to evaluate the quality of outcome indicators.Results:Eight systematic reviews/meta-analyses were finally included,and only three were of high quality.The main defects were that the publication status of the included literature was not considered,the search strategy was not repeatable,and the relevant conflicts of interest were not stated.The quality of the 10 outcome indicators of 8 systematic reviews was evaluated.Of them,the quality of the two outcome indicators was low,and that of the rest was extremely low.Conclusion:The overall quality of the included systematic review/meta-analysis literature is not high,and the quality of the outcome index evidence is mainly extremely low.The application effect of TIVAP is better than PICC,but the incidence of accidental artery penetration and pneumothorax is higher than that of PICC.Due to the low quality of the evidence,higher quality studies are still needed for further corroboration.

关 键 词：经外周静脉留置中心静脉导管 完全植入式输液港 应用效果 GRADEpro GDT 系统评价再评价 

分 类 号：R472[医药卫生—护理学]