在导管相关的血栓形成中,左侧和右侧手臂口和胸口之间是否存在差异?
Yun Fan1, Huarong Du1, Yuanyuan Guan2
1Department of Gastrointestinal and Rectal Surgery, Shapingba Hospital Affiliated to Chongqing University (Shapingba District People's Hospital of Chongqing), Chongqing, China.
Frontiers in surgery
|March 9, 2026
概括
这次元分析发现,左侧和右侧完全植入式静脉接入口 (TIVAPs) 之间的导管相关血栓形成风险 (CRT) 没有显著差异. 然而,左侧TIVAP植入可能会在大型患者队列中显示出略高的CRT风险.
科学领域:
- 血管外科 血管外科
- 在瘤学瘤学.
- 医疗器械 医疗器械
背景情况:
- 完全可植入的静脉接入口 (TIVAP) 对于长期的静脉治疗至关重要,特别是在癌症患者中.
- 对于TIVAPs,植入侧 (左侧或右侧) 的选择是有争议的,因为它可能对导管相关血栓形成 (CRT) 产生解剖学和血液动力学影响.
- 现有的文献缺乏关于TIVAP植入侧是否影响CRT发病率的共识.
研究的目的:
- 系统评估左侧与右侧TIVAP植入物对导管相关血栓瘤 (CRT) 风险的影响.
- 为临床决策提供基于证据的指导,用于选择TIVAP植入部位.
- 为了解决围绕TIVAP植入侧和CRT风险之间的关联的争议.
主要方法:
- 在多个数据库 (PubMed,Embase,Web of Science等) 进行全面的文献搜索. 在2025年10月之前.
- 包括包括10778名患者的21项研究.
- 使用RevMan 5.3进行的元分析,独立提取数据和偏差风险评估.
主要成果:
- 对于胸部口 (OR=1.28,P=0.08) 或手臂口 (OR=1.19,P=0.29) 的CRT发生率没有发现统计学上显著的差异.
- 该分析包括21项研究中的10,778名患者.
- 一个潜在的样本大小依赖的关联表明,在较大的队列中,左侧植入的CRT风险略高.
结论:
- 目前的证据表明,在左侧和右侧TIVAP植入之间,CRT发生率没有整体差异.
- 在大规模研究中,左侧植入可能与CRT风险略有增加有关.
- 进一步的大规模,多中心随机对照试验是必要的,以证实这些发现和指导临床实践.
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