与外围插入的中央导管相关的静脉血栓栓塞的风险:系统性审查和元分析
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
概括
与其他中央静脉导管 (CVC) 相比,外围插入的中央导管 (PICC) 会增加深静脉血栓形成的风险. 这种风险在重症患者和癌症患者中更高,需要仔细考虑益处与血栓形成风险.
科学领域:
- 血管接入装置 血管接入装置
- 血栓形成的研究研究
- 医疗器械安全 医疗器械安全
背景情况:
- 外围插入的中央导管 (PICC) 与静脉血栓栓塞的发病率较高有关.
- 在PICCs和其他中央静脉导管 (CVCs) 之间,静脉血栓栓塞的比较风险尚不清楚.
研究的目的:
- 进行系统性审查和元分析,比较与PICC相关的静脉血栓塞栓症风险与其他CVC相关的风险.
主要方法:
- 在多个数据库 (Medline,Embase,Scopus等) 中进行全面的搜索. 并且进行了手搜.
- 包括成人患者接受PICC插入的人类研究,使用纽卡斯尔-太华尺度进行评估.
- 聚合频率和随机效应元分析被用来计算静脉血栓栓塞的几率比率.
主要成果:
- 64项涉及29503名患者的研究符合资格标准.
- 与CVC相比,使用PICC与深静脉血栓形成的风险增加有关 (OR2.55,p<0.0001).
- 伤害所需的数量为26,在危急病患者和癌症患者中观察到更高的风险.
结论:
- PICC与CVC相比,与深静脉血栓形成的风险明显高.
- 这种增加的风险在危急病患者和患有恶性瘤的患者中尤为明显.
- 关于PICC插入的临床决定应该平衡设备的益处与血栓形成的风险增加.
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