成人经外周静脉置入中心静脉导管相关性血栓风险预测模型的系统评价  

Systematic review of thrombosis risk prediction models related to peripherally inserted central catheter

作　　者：吴晓琦 杨丽红[2] 安志洁[3] 石静[1] 盛源 高伟[4] Wu Xiaoqi;Yang Lihong;An Zhijie;Shi Jing;Sheng Yuan;Gao Wei(School of Nursing and Rehabilitation,Shandong University,Jinan 250012,China;Department of Hematology,Liaocheng People's Hospital,Liaocheng 252000,China;Department of Oncology,Qingdao Municipal Hospital,Qingdao 266071,China;PICC Clinic,Qilu Hospital of Shandong University,Jinan 250012,China)

机构地区：[1]山东大学护理与康复学院,济南250012 [2]聊城市人民医院血液科,聊城252000 [3]青岛市市立医院肿瘤科,青岛266071 [4]山东大学齐鲁医院PICC门诊,济南250012

出　　处：《中华现代护理杂志》2024年第17期2263-2272,共10页Chinese Journal of Modern Nursing

摘　　要：目的系统评价成人经外周静脉置入中心静脉导管(PICC)相关性血栓风险预测模型,为预测模型在临床中的应用和后续模型的开发提供依据。方法计算机检索中国知网、万方数据知识服务平台、维普网、PubMed、CINAHL、Webof Science、Ovid数据库,搜集关于成人PICC相关性血栓风险预测模型的研究,检索时限均从建库至2022年12月31日。由2名研究者独立筛选文献、提取数据并进行偏倚风险评价。结果共纳入19项研究。D-二聚体是最常见的预测因子;仅5项研究进行了外部验证,6项研究进行了模型校准度评价;纳入研究均有较高的偏倚风险,主要原因为模型构建和验证过程中存在方法学方面的不足;其中9项模型的合并受试者工作特征曲线下面积为0.80(95%置信区间:0.75~0.85)。结论成人PICC相关性血栓风险预测模型的研究仍处于发展阶段,大部分已知的预测模型性能较好,预测因子纳入全面且易获取,但存在方法学方面的不足,建议未来的研究应重视模型开发和验证过程中的方法学质量和外部验证。Objective To systematically review thrombosis risk prediction models associated with peripherally inserted central venous catheter(PICC)in adults and provide a basis for the clinical application of these models and the development of subsequent models.Methods Databases such as CNKI,Wanfang,VIP,PubMed,CINAHL,Web of Science,and Ovid were searched to collect studies on thrombosis risk prediction models related to adult PICC,covering all entries from the inception of the databases until December 31,2022.Two researchers independently screened the literature,extracted data,and assessed the risk of bias.Results Nineteen studies were included.D-dimer was the most common predictive factor;only five studies underwent external validation,and six studies evaluated model calibration.All included studies exhibited high risk of bias,primarily due to methodological deficiencies in model development and validation processes;the combined area under the receiver operating characteristic curve for nine models was 0.80(95% Confidence Interval:0.75-0.85).Conclusions Research on thrombosis risk prediction models related to adult PICC is still in its developmental stage.Most of the known models perform well with comprehensive and easily obtainable predictive factors,yet they exhibit methodological shortcomings.Future research should focus on improving the methodological quality and external validation during model development and validation processes.

关 键 词：静脉 经外周静脉置入中心静脉导管 导管相关性血栓 预测模型 系统评价 

分 类 号：R47[医药卫生—护理学]