Author Affiliations: School of Nursing, Nanjing University of Chinese Medicine (Mss Pan, Li, and Fang and Mr Du); and Department of Nursing (Mss Meng and Zhu), Outpatient Clinic (Mss Zhi, Shi, and Cheng), Thoracic Surgery (Dr Yin), and General Surgery (Breast Tumours) (Ms Sun), Jiangsu Cancer Hospital, Nanjing, Jiangsu Province, China.
Cancer Nurs. 2019 Nov/Dec;42(6):E49-E58. doi: 10.1097/NCC.0000000000000664.
Cancer patients are considered the most at risk of the consequences of catheter occlusion. Therefore, nursing interventions that can effectively reduce the occlusion of peripherally inserted central catheter (PICC) lines must be identified to ensure a smooth treatment.
This study aimed to evaluate nursing interventions to minimize PICC line occlusion and make recommended measures for preventing or decreasing occlusion and abnormal extubation.
Studies about PICC occlusion that were published up to January 2017 were searched and screened in PubMed, Web of Science, Science Direct (Elsevier), EMBASE, Cochrane Library, and Chinese databases CNKI and Wanfang. Two independent reviewers screened the literature in accordance with the inclusion and exclusion criteria, assessed the quality of the included studies, and extracted the data. Further meta-analysis was performed using RevMan 5.3.
Thirteen trials were included. Meta-analysis revealed that education for nurses (relative risk, 0.31; 95% confidence interval, 0.19-0.51; P < .00001) was significantly associated with PICC occlusion, whereas PICC type (relative risk, 0.60; 95% confidence interval, 0.32-1.15; P = .12) was not significantly associated with PICC occlusion. The solution to washing pipes and the PICC insertion techniques were descriptively analyzed to reach statistical significance.
This study determined the correlation of PICC occlusion with the nurses' knowledge and skills, PICC types, flushing liquid and methods, and insertion techniques.
The findings of this study can serve as a guide for clinical work and for developing targeted measures to reduce occlusion.
癌症患者被认为是导管阻塞后果风险最高的人群。因此，必须确定能够有效减少外周置入中心静脉导管（PICC）阻塞的护理干预措施，以确保治疗的顺利进行。
本研究旨在评估最小化 PICC 导管阻塞的护理干预措施，并为预防或减少阻塞和异常拔管提出推荐措施。
检索 PubMed、Web of Science、Science Direct（Elsevier）、EMBASE、Cochrane Library 和中国数据库 CNKI 和万方，查找截至 2017 年 1 月发表的有关 PICC 阻塞的研究，并进行筛选。两位独立评审员按照纳入和排除标准筛选文献，评估纳入研究的质量，并提取数据。进一步使用 RevMan 5.3 进行荟萃分析。
纳入了 13 项试验。Meta 分析显示，护士教育（相对风险，0.31；95%置信区间，0.19-0.51；P<0.00001）与 PICC 阻塞显著相关，而 PICC 类型（相对风险，0.60；95%置信区间，0.32-1.15；P=0.12）与 PICC 阻塞不相关。冲洗管道的溶液和 PICC 插入技术进行了描述性分析，达到了统计学意义。
本研究确定了 PICC 阻塞与护士的知识和技能、PICC 类型、冲洗液和方法以及插入技术之间的相关性。
本研究的结果可为临床工作提供指导，并为制定有针对性的减少阻塞措施提供依据。
