周回的に挿入された中央カテーテルに関連した静脈性血栓栓塞栓のリスク:体系的なレビューとメタ解析
Vineet Chopra1, Sarah Anand, Andy Hickner
1Department of Internal Medicine, Division of General Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA. vineetc@umich.edu
Lancet (London, England)
|May 24, 2013
まとめ
周回的に挿入された中央カテーテル (PICC) は,他の中央静脈カテーテル (CVC) と比較して,深静脈血栓症のリスクを増加させます. このリスクは,重症患者およびがん患者の場合より高く,利益と血栓形成のリスクを慎重に考慮する必要がある.
科学分野:
- 血管へのアクセス装置
- トロンボシス研究研究
- 医療機器の安全性 医療機器の安全性について
背景:
- 周回的に挿入された中央カテーテル (PICC) は,静脈血栓塞栓症のより高い発生率と関連しています.
- PICCsと他の中央静脈カテーテル (CVCs) の間の静脈血栓栓塞栓症の比較リスクは不明のままです.
研究 の 目的:
- PICCsと関連した静脈血栓塞栓症のリスクを他のCVCsと比較する体系的なレビューとメタ解析を実施する.
主な方法:
- 複数のデータベース (Medline,Embase,Scopusなど) の包括的な検索 そして,手探りが行われました.
- PICC挿入を受けた成人患者のヒト研究も含まれており,ニューカッスル・オタワスケールを使用して評価されました.
- プールの頻度とランダム効果のメタ解析を用いて,静脈血栓塞栓症の確率比率を計算した.
主要な成果:
- 29,503人の患者を対象とした64件の研究は,適格性基準を満たした.
- PICCの使用は,CVCと比較して,深静脈血栓形成のリスクの増加 (OR 2.55,p<0.0001) と関連していました.
- 傷つけるのに必要な数は26で,重症患者やがん患者でリスクが高かった.
結論:
- PICCは,CVCよりも深い静脈血栓症のリスクが著しく高いと関連しています.
- この増加したリスクは,特に重症患者および悪性腫瘍を有する患者で顕著です.
- PICCの挿入に関する臨床的決定は,デバイスの利点と血栓形成のリスクの増大をバランスとする必要があります.
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