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硅胶和聚氨酯经外周静脉穿刺中心静脉置管(PICC)导管的比较及置管后并发症发生率:一项系统评价

A comparison of silicone and polyurethane PICC lines and postinsertion complication rates: a systematic review.

作者信息

Seckold Tammy, Walker Sandra, Dwyer Trudy

机构信息

Central Queensland University, Queensland - Australia.

出版信息

J Vasc Access. 2015 May-Jun;16(3):167-77. doi: 10.5301/jva.5000330. Epub 2015 Jan 23.

Abstract

PURPOSE

To determine postinsertion complication rate for peripherally inserted central catheters (PICCs), in particular the difference between silicone and polyurethane lines in general population groups as well as oncology and non-oncology patient groups.

METHODS

A systematic review of prospective and retrospective studies in the English language between January 2000 and October 2013 focusing on postinsertion complication rates for PICCs in the adult population. Joanna Briggs Institute tools were used to extract data from the final 19 articles with information collated relating to catheter type, patient type, overall complication rate, rates of infection, occlusion, dislodgment, phlebitis, thrombus and rupture.

RESULTS

Overall, the PICCs complication rates ranged from 8 to 50%. Although both lines saw similar overall rates upon closer observation, the strengths and weaknesses of both lines are shown.Polyurethane PICC lines were found to provide lower rates of infection, dislodgment, thrombus and rupture complications.Mixed results were found with catheter line occlusions, overall averages showing polyurethane lines slightly higher rates than silicone. Oncology patients however saw opposite results.Phlebitis rates saw the largest division among the postinsertion complication rates, with 6.7% more phlebitis in the general patient group and 14.5% in the oncology group more for those with polyurethane PICC lines compared with the silicone.

CONCLUSIONS

Both silicone and polyurethane PICC lines exhibit nearly identical overall average postinsertion compilation rates; however, it is the type of complications experienced that differ. Overall, oncology patients can expect to experience higher levels of postinsertion complications.

摘要

目的

确定经外周静脉穿刺中心静脉导管(PICC)置入后的并发症发生率,特别是在普通人群组以及肿瘤和非肿瘤患者组中硅胶导管和聚氨酯导管之间的差异。

方法

对2000年1月至2013年10月期间以英文发表的前瞻性和回顾性研究进行系统评价,重点关注成年人群中PICC置入后的并发症发生率。使用乔安娜·布里格斯研究所的工具从最终的19篇文章中提取数据,整理与导管类型、患者类型、总体并发症发生率、感染率、堵塞率、移位率、静脉炎、血栓形成和破裂相关的信息。

结果

总体而言,PICC的并发症发生率在8%至50%之间。尽管仔细观察发现两种导管的总体发生率相似,但两种导管的优缺点也有所体现。发现聚氨酯PICC导管的感染、移位、血栓形成和破裂并发症发生率较低。导管堵塞的结果不一,总体平均显示聚氨酯导管的发生率略高于硅胶导管。然而,肿瘤患者的结果则相反。静脉炎发生率在置入后并发症发生率中差异最大,与硅胶导管相比,普通患者组中使用聚氨酯PICC导管的患者静脉炎发生率高6.7%,肿瘤患者组高14.5%。

结论

硅胶和聚氨酯PICC导管的总体平均置入后并发症发生率几乎相同;然而,所经历的并发症类型有所不同。总体而言,肿瘤患者预计会经历更高水平的置入后并发症。

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