Nursing Department of Zhujiang Hospital, Southern Medical University, Guangzhou, China.
Oncology Department of Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.
J Adv Nurs. 2018 Nov;74(11):2484-2496. doi: 10.1111/jan.13766. Epub 2018 Jul 25.
The aim of this study was to compare peripheral arm ports versus central chest ports in complication rates.
Late complications of arm ports versus chest ports, including catheter-related infection, venous thrombosis and catheter obstruction, remain controversial.
A meta-analysis conducted following the Cochrane handbook.
Studies published between 1950-August 2017 were searched through Pubmed, Embase, Web of science and Cochrane library.
Two authors independently searched the eligible studies and extracted the data. Studies reporting complications of arm ports compared with chest ports, published in full texts and abstracts, were included. The quality of the studies was assessed with the Newcastle-Ottawa Scale. We did subgroup analyses according to cancer type, age, follow-up and anticoagulant. Relative ratios were calculated with different models.
A total of 15 articles covering 3,524 tumour patients met the eligibility criteria. There was no difference in catheter-related infection and catheter obstruction between arm ports and chest ports. After reducing the high heterogeneity, no difference was observed in thrombosis overall; however, arm ports had a lower thrombosis rate than chest ports in patients with head and neck cancer, while a higher thrombosis rate was observed in patients <60 years old or follow up ≥1 year. Further studies are needed in venous thrombosis.
Arm ports are a safe option beside chest ports for adult patients with malignancy, especially in patients with head-neck cancer or breast cancer. Patients should be well informed of the advantages and disadvantages of different vascular access devices and provided a choice.
本研究旨在比较外周臂港与中央胸港的并发症发生率。
关于臂港与胸港的晚期并发症，包括导管相关性感染、静脉血栓形成和导管阻塞，仍存在争议。
根据 Cochrane 手册进行的荟萃分析。
通过 Pubmed、Embase、Web of science 和 Cochrane library 检索了 1950 年 8 月至 2017 年期间发表的研究。
两位作者独立检索了合格的研究并提取了数据。纳入了报告臂港与胸港并发症的研究，这些研究以全文和摘要形式发表。使用纽卡斯尔-渥太华量表评估研究质量。我们根据癌症类型、年龄、随访和抗凝进行了亚组分析。使用不同的模型计算了相对比值。
共有 15 篇文章涵盖了 3524 名肿瘤患者，符合入选标准。在导管相关性感染和导管阻塞方面，臂港和胸港之间没有差异。在降低高异质性后，总的血栓形成没有差异；然而，在头颈部癌症患者中，臂港的血栓形成率低于胸港，而在<60 岁或随访时间≥1 年的患者中，血栓形成率较高。静脉血栓形成还需要进一步研究。
对于成年恶性肿瘤患者，臂港是除胸港之外的一种安全选择，尤其是在头颈部癌症或乳腺癌患者中。应向患者充分告知不同血管通路装置的优缺点，并提供选择。
