在儿科瘤学中采用道外置与植入端口中央静脉导管:系统性审查和元分析
Jonathan J Neville1, Hinn Moe Aye2, Nigel J Hall3
1University Surgery Unit, Faculty of Medicine, University of Southampton, Southampton, UK.
Archives of disease in childhood
|July 25, 2023
概括
与道外部中央静脉导管 (CVC) 相比,植入端口 (PORT) 减少了儿科癌症患者的感染和机械并发症. 此外,PORT还导致提前清除的数量减少,从而改善患者的治疗结果.
科学领域:
- 儿科瘤学 儿科瘤学
- 医疗器械 医疗器械
- 临床研究 临床研究
背景情况:
- 中枢静脉导管 (CVC) 对于在儿童癌症患者中进行化疗和支持性护理至关重要.
- 道外 CVC 和植入端口 (PORT) 都是常用的,每一个都有潜在的并发症.
- 评估和比较不同类型的CVC的安全性和有效性对于优化患者护理至关重要.
研究的目的:
- 在患有癌症的儿童中,系统地审查和比较与道外 CVC 与 PORT 相关的并发症.
- 确定哪种CVC类型在感染,机械故障和其他不良事件方面具有更好的安全性.
- 为儿童瘤学中CVC选择提供基于证据的建议.
主要方法:
- 按照PRISMA指南进行了系统审查和元分析.
- 搜索的数据库包括MEDLINE,科学网和科克兰图书馆.
- 包括的研究比较了道化外部CVC和PORT在患有恶性瘤的18岁以下的患者中,分析了感染,机械故障和移除率等结果.
主要成果:
- 道化外部CVC与系统性感染 (OR 2.10) 和机械并发症 (OR 2.47) 的风险显著增加有关.
- 在两种CVC类型之间的局部感染率中没有发现显著差异.
- 与PORT相比,道式外部CVC也显示出提前移除设备的风险更高 (OR 3.24) .
结论:
- 植入端口 (PORT) 与儿童癌症患者的道外 CVC 相比,与传染病和机械并发症的风险降低有关.
- PORT 显示设备提前移除的整体风险较低.
- 需要进一步的前性随机试验来确认这些发现,并评估成本效益和患者/护理人员的可接受性.
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