儿童中枢静脉接入装置切除过程中的并发症:系统性审查和元分析
Mahesh Sakthivel1, Danesh Sakthivel2, Ramesh M Nataraja3
1Department of Paediatrics, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia; Alfred Health, Melbourne, Australia.
Journal of pediatric surgery
|July 7, 2025
概括
在儿童中切除中央静脉通道装置 (CVAD) 的并发症与更长的停留时间和急性淋巴细胞白血病 (ALL) 诊断有关. 需要进一步的研究来防止这些机械问题.
科学领域:
- 儿科瘤学 儿科瘤学
- 医疗器械 医疗器械 医疗器械
- 干预性放射学是干预性的放射学.
背景情况:
- 中枢静脉接入装置 (CVAD) 切除过程中的机械并发症,如粘附或碎片化,对儿科患者构成风险.
- 确定这些并发症的发病率和风险因素对于改善患者安全至关重要.
研究的目的:
- 为了确定在儿童中切除CVAD时出现并发症的发生率.
- 确定与这些并发症相关的风险因素.
主要方法:
- 从1970年到2024年,按照PRISMA指南进行了系统审查.
- 分析了11项涉及4019个CVAD移除的回顾性研究,使用随机效应模型进行元分析.
- 使用ROBINS-I工具评估了研究质量.
主要成果:
- 在儿童中,CVAD移除并发症的总发病率为5.6%,观察到显著的异质性.
- 对整体并发症的关键风险因素包括停留时间>2年,急性淋巴细胞白血病 (ALL) 诊断和聚氨导管.
- 留住导管的特定危险因素包括更长的内置时间和ALL诊断.
结论:
- 较长的停留时间 (>2年) 和ALL诊断是复杂的儿科CVAD移除的重要风险因素.
- 其他潜在的风险因素包括导管材料,插入时的年龄较小,以及较小的光线尺寸.
- 建议进行进一步的大规模前性研究,以验证这些发现并为预防策略提供信息.
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