系统性抗癌疗法 (CAVA) 中枢静脉接入装置:随机对照试验
Jonathan G Moss1, Olivia Wu2, Andrew R Bodenham3
1Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.
Lancet (London, England)
|July 23, 2021
概括
完全植入的端口 (PORT) 比希克曼型道导管 (Hickman) 和外围插入的中心导管 (PICC) 更安全,更有效地提供全身抗癌治疗 (SACT). 这些发现支持在英国患者中使用PORT治疗SACT.
科学领域:
- 癌症学
- 医疗器械
- 临床试验
背景情况:
- 希克曼型道导管 (Hickman),外围插入的中央导管 (PICC) 和完全植入的端口 (PORT) 是用于全身抗癌治疗 (SACT) 的中央静脉接入装置.
- 对这些设备的并发症率和成本进行比较对于确定其在SACT治疗中的临床有效性和成本效益至关重要.
研究的目的:
- 在接受SACT的患者中比较Hickman,PICC和PORT的并发症率和成本.
- 确定这三种中央静脉接入装置的可接受性,临床有效性和成本效益.
主要方法:
- 这是一项开放的多中心随机对照试验 (CAVA),涉及18个英国瘤病房的成年人接受SACT治疗.
- 进行了三个比较:PICC与Hickman (非劣势),PORT与Hickman (优势),PORT与PICC (优势).
- 主要结局是复杂症的复合率,评估到设备的移除,研究的退出,或1年的随访.
主要成果:
- 在PICCs (52%) 和Hickman (49%) 之间观察到类似的并发症率,而PICCs未被证实为非劣质.
- 与希克曼相比,PORT的安全性和有效性更高 (29%对43%的并发症率).
- 此外,PORT的复杂性比PICC更低 (32%与47%相比).
结论:
- 对于接受SACT的大多数患者来说,完全植入的端口 (PORT) 比Hickman和PICC更有效和更安全.
- 这些发现强烈表明,PORT应该是英国国家卫生服务中SACT输送的首选中央静脉接入装置.
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