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经外周静脉穿刺中心静脉置管(PICC)与完全植入式静脉输液港(PORT)在妇科癌症患者化疗中的应用:一项荟萃分析。

Peripherally Inserted Central Venous Catheters (PICC) versus totally implantable venous access device (PORT) for chemotherapy administration: a meta-analysis on gynecological cancer patients.

机构信息

Department of medicine and surgery, University of Parma..

Department of gynecologic oncology, University of Palermo..

出版信息

Acta Biomed. 2021 Nov 3;92(5):e2021257. doi: 10.23750/abm.v92i5.11844.

Abstract

BACKGROUND AND AIM

Ninety-four thousand gynecological cancer diagnoses are performed each year in the United States. The majority of these tumors require systemic adjuvant therapy. Sustained venous access was overcome by indwelling long-term central venous catheter (CVC). The best choice of which CVC to use is often arbitrary or dependent on physician confidence. This meta-analysis aims to compare PORT and peripherally inserted central catheter (PICC) outcomes during adjuvant treatment for gynecological cancer.

METHODS

Meta-analysis Of Observational Studies in Epidemiology (MOOSE) and the preferred reporting items for systematic reviews and meta-analyses statement (PRISMA)were used to conduct the meta-analysis.

RESULTS

1320 patients were included, 794 belonging to the PORT group and 526 to the PICC group. Total complication rates were fewer in the PORT group, p = 0.05. CVC malfunction was less frequent in the PORT group than in the PICC group, p <0.01. Finally, thrombotic events were less expressed in the PORT group than in the PICC group, p = 0.02. No difference was found in operative complication, migration, malposition, extravasation, infection, and complication requiring catheter removal.

CONCLUSIONS

PORT had fewer thrombotic complications and fewer malfunction problems than PICC devices. Unless specific contraindications, PORTs can be preferred for systemic treatment in gynecological cancer patients.

摘要

背景与目的

美国每年进行 94000 例妇科癌症诊断。这些肿瘤中的大多数需要系统辅助治疗。留置式长期中央静脉导管(CVC)克服了持续静脉通路的问题。最佳 CVC 选择通常是任意的,或者取决于医生的信心。本荟萃分析旨在比较妇科癌症辅助治疗中 PORT 和外周插入中心导管(PICC)的结果。

方法

采用观察性研究荟萃分析(MOOSE)和系统评价和荟萃分析报告的首选项目(PRISMA)进行荟萃分析。

结果

共纳入 1320 例患者,其中 794 例属于 PORT 组,526 例属于 PICC 组。PORT 组总并发症发生率较低,p = 0.05。PORT 组 CVC 故障发生率低于 PICC 组,p <0.01。最后,PORT 组血栓事件发生率低于 PICC 组,p = 0.02。在手术并发症、迁移、错位、外渗、感染和需要导管移除的并发症方面,两组间无差异。

结论

PORT 比 PICC 装置发生血栓并发症和故障的情况更少。除非有特定的禁忌症,否则 PORT 可优先用于妇科癌症患者的全身治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/04c3/8689318/a9488befc4af/ACTA-92-257-g001.jpg

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