Shantou University Medical College, Shantou, China.
The First Affiliated Hospital of Shantou University Medical College, Shantou, China.
J Vasc Access. 2021 Sep;22(5):814-821. doi: 10.1177/1129729820950998. Epub 2020 Sep 1.
Recently, some studies have shown that prolonging flush interval is safe and feasible for patients who complete chemotherapy. However, there is no consensus about the optimal flush interval for those patients.
The purpose of this review was to evaluate whether the flush interval could be prolonged based on monthly interval for regular maintenance and to explore the optimal flush interval.
We searched the following databases for articles published between 1 January 1982 and 21 February 2020: PubMed, Cochrane Library, Web of Science, EMBASE, CINAHL, and Ovid.
Randomized controlled trials, retrospective and prospective cohort studies of flush interval less than 4 weeks versus longer than 4 weeks for patients who completed chemotherapy, were included.
Two reviewers extracted information and assessed the quality of the articles independently. In total, 389 articles were retrieved, and 4 studies including 862 cases fulfilled the inclusion criteria. There was no statistical heterogeneity ( = 0, > 0.05) among the included studies. Hence, the fixed-effects model was used for the meta-analysis. The meta-analysis showed that the total complication rate associated with longer than 4-week interval was higher than that associated with less than 4-week interval. Nevertheless, there was no significant difference between the two groups (7.2% vs 7.6%, = 0.83). Moreover, the meta-analysis showed that the total complication and catheter occlusion rates associated with the 4-week interval were higher than those associated with the 8-week interval. However, there was no significant difference between the two groups (total complications: 11.4% vs 9.5%, = 0.68; catheter occlusions: 4.9% vs 4.1%, = 0.89).
Only four non-randomized controlled studies were included, and the outcomes of the included studies were reported incompletely.
Extending the flush interval to longer than 4 weeks is safe and feasible. Based on previous studies, extending the flush interval to 8 weeks might not increase the incidence of total complications and catheter occlusions. However, there is no conclusion on whether the flush interval could be extended to 3 months or longer.
最近，一些研究表明，对于已完成化疗的患者，延长冲洗间隔是安全且可行的。然而，对于这些患者，最佳冲洗间隔时间尚无共识。
本综述旨在评估是否可以基于每月常规维持的间隔时间来延长冲洗间隔，并探讨最佳冲洗间隔。
我们检索了以下数据库，以获取 1982 年 1 月 1 日至 2020 年 2 月 21 日期间发表的文章：PubMed、Cochrane 图书馆、Web of Science、EMBASE、CINAHL 和 Ovid。
纳入冲洗间隔时间小于 4 周与大于 4 周的随机对照试验、回顾性和前瞻性队列研究，这些研究对象均为已完成化疗的患者。
两名审查员独立提取信息并评估文章质量。共检索到 389 篇文章，其中 4 项研究（862 例患者）符合纳入标准。纳入的研究之间无统计学异质性（ = 0， ＞0.05）。因此，使用固定效应模型进行荟萃分析。荟萃分析显示，总并发症发生率与大于 4 周的冲洗间隔相关，高于小于 4 周的冲洗间隔。然而，两组之间无显著差异（7.2%比 7.6%， = 0.83）。此外，荟萃分析显示，4 周冲洗间隔的总并发症和导管阻塞发生率高于 8 周冲洗间隔。然而，两组之间无显著差异（总并发症：11.4%比 9.5%， = 0.68；导管阻塞：4.9%比 4.1%， = 0.89）。
仅纳入了四项非随机对照研究，且纳入研究的结果报告不完整。
延长冲洗间隔至大于 4 周是安全且可行的。基于既往研究，将冲洗间隔延长至 8 周可能不会增加总并发症和导管阻塞的发生率。但是，对于冲洗间隔是否可以延长至 3 个月或更长时间，尚无结论。
