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导管相关血栓形成的患者相关危险因素的系统评价。

A systematic review of patient-related risk factors for catheter-related thrombosis.

作者信息

Leung Amy, Heal Clare, Perera Marlon, Pretorius Casper

机构信息

School of Medicine and Dentistry, James Cook University, Mackay Base Hospital, 475 Bridge Road, Mackay, QLD, 4650, Australia,

出版信息

J Thromb Thrombolysis. 2015 Oct;40(3):363-73. doi: 10.1007/s11239-015-1175-9.

Abstract

To identify patient-related risk factors for venous thrombosis in patients with central venous catheters (CVC) or peripherally inserted central catheters (PICC). We performed a systematic review of the literature assessing patient-related risk factors for thrombosis related to CVC or PICC. The databases PubMed, Ovid and the Cochrane library were searched for observational studies pertaining to patient-related risk factors for CVC and PICC-related thrombosis. The initial search through PubMed, Ovid and the Cochrane library yielded 516 results. After 71 duplicates were removed, 445 articles were assessed for eligibility based on title and abstract. Four hundred and eleven articles were then excluded and 33 full text articles were manually assessed for eligibility. Eight articles were eliminated as they did not contain content relevant to the review. Twenty-five studies were then selected to assess 20 risk factors. There were no consistent significant associations for catheter-related thrombosis across the twenty-five studies. Multiple studies identified age, malignancy, diabetes, obesity, chemotherapy, thrombophilia and a history of thrombosis as significant risk factors for catheter-related thrombosis. Inconsistent findings among studies make it difficult to establish which patient-related risk factors are associated with catheter-related thrombosis. Future studies could include larger sample sizes and more cases of catheter-related thrombosis to produce more significant results. Identification of patient-related risk factors could lead to early recognition of upper limb deep vein thrombosis in patients with catheters, thereby preventing complications.

摘要

为了确定中心静脉导管(CVC)或外周静脉置入中心静脉导管(PICC)患者发生静脉血栓形成的患者相关危险因素。我们对评估与CVC或PICC相关的血栓形成的患者相关危险因素的文献进行了系统综述。检索了PubMed、Ovid和Cochrane图书馆数据库,以查找与CVC和PICC相关血栓形成的患者相关危险因素的观察性研究。通过PubMed、Ovid和Cochrane图书馆的初步检索产生了516条结果。在去除71条重复项后,根据标题和摘要对445篇文章进行了资格评估。然后排除了411篇文章,并对33篇全文文章进行了资格人工评估。由于8篇文章不包含与综述相关的内容而被排除。然后选择25项研究来评估20个危险因素。在这25项研究中,对于导管相关血栓形成没有一致的显著关联。多项研究确定年龄、恶性肿瘤、糖尿病、肥胖、化疗、血栓形成倾向和血栓形成病史是导管相关血栓形成的显著危险因素。研究结果不一致使得难以确定哪些患者相关危险因素与导管相关血栓形成有关。未来的研究可以纳入更大的样本量和更多导管相关血栓形成的病例,以产生更显著的结果。识别患者相关危险因素可导致对有导管患者的上肢深静脉血栓形成进行早期识别,从而预防并发症。

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