对于儿科完全可植入静脉口的内部与外部关静脉接入:系统性审查和元分析
Khadeeja Ali Hamzah1, Yousif Hameed Kurmasha2, Mohammedsadeq A Shweliya3
1Baghdad University AIkindy College of Medicine, Baghdad, Iraq.
Pediatric surgery international
|June 19, 2025
概括
对于儿科瘤患者的完全植入式静脉接入口 (TIVAPs) 的外静脉 (EJV) 接入,可显著减少手术时间. 这种方法提供了与内静脉 (IJV) 接入相似的安全性,可能最大限度地减少麻醉需求.
科学领域:
- 儿科手术 儿科手术
- 血管接入 血管接入
- 在瘤学瘤学.
背景情况:
- 完全可植入的静脉接入口 (TIVAPs) 对需要长期静脉治疗的儿科瘤患者至关重要.
- 内静脉 (IJV) 接入是常见的,但存在解剖学上的挑战,可能需要全身麻醉.
- 外静脉 (EJV) 接入是一个潜在的替代方案,因为它的表面位置和程序优势.
研究的目的:
- 评估EJV与IJV接入的疗效和安全性,用于儿童瘤病人的TIVAP安置.
- 确定EJV接入与IJV接入相比,在操作时间和并发症率方面是否具有优势.
主要方法:
- 在2025年1月之前对PubMed,Scopus,Web of Science,Embase和EBSCO数据库进行系统审查.
- 包括比较通过IJV和EJV在18岁以下的患者中插入TIVAP的研究,遵守PRISMA指南.
- 使用Cochrane偏差风险和纽卡斯尔-太华尺度进行质量评估,并使用RevMan 5.4.4进行元分析.
主要成果:
- 分析了三项涉及315名儿科患者 (160名EJV,155名IJV) 的研究.
- 通过EJV访问,操作时间显著缩短 (平均差异: -24.80分钟; p < 0.0001).
- 在EJV和IJV组之间没有观察到并发症率 (血瘤,肺胸,血栓,导管问题) 的显著差异.
结论:
- 在儿科瘤患者的TIVAP安置中,EJV访问与手术时间的缩短有关.
- 与IJV访问相比,EJV访问不会增加并发症的风险.
- 静脉关节可能是首选的静脉接入部位,特别是当最大限度地减少麻醉暴露是首要任务时.
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