外周置入中心静脉导管与植入式端口导管用于癌症患者的比较：一项荟萃分析。

Peripherally inserted central catheters versus implantable port catheters for cancer patients: a meta-analysis.

作者信息

Lin Li, Li Wei, Chen Chen, Wei Anhua, Liu Yu

机构信息

Department of Oncology, Wuhan Asia General Hospital, Wuhan, China.

Department of Pharmacy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

出版信息

Front Oncol. 2023 Jul 14;13:1228092. doi: 10.3389/fonc.2023.1228092. eCollection 2023.

BACKGROUND

The implanted vascular access ports (PORTs) were compared with peripherally inserted central catheters (PICCs) as the administration of chemotherapy regarding different clinical effects and adverse effects. Which is better is debatable. Hence, the current study was conducted to assess the safety and efficacy of these two optimal vascular access strategies.

METHODS

The following electronic databases were searched: PubMed, Embase, and the Cochrane Library updated in May 2023. Studies on the differences in complication rates in patients with cancer using either PICC or PORT for chemotherapy were included. Meta-analysis Revman 5.3 software was used for statistical analysis.

RESULTS

A total of 22 articles were retrieved. The results suggested that PORT has a superior safety profile, with lower incidences of overall adverse effects (OR=2.72, 95% CI=1.56-4.72 P=0.0004), catheter-related thrombosis (OR=2.84, 95% CI=1.97-4.11, P<0.00001), and allergic reactions (OR=6.26, 95% CI=1.86-21.09, P=0.003) than typically expected with PICC. Moreover, PICC was non-inferior to the PORT group with respect to DVT (OR=2.00, 95% CI=0.86-4.65, P=0.11) and infection (OR=1.55, 95% CI=0.75-3.22, P=0.24).

CONCLUSION

PORT achieved safety benefits compared with chemotherapy through PICC. Therefore, PORT is regarded as safe and effective vascular access for the administration of chemotherapy. When considering economic factors and some key elements, more high-quality research would help verify these clinical benefits.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/prospero/, identififier CRD42023421690.

背景

将植入式血管通路端口（PORT）与经外周静脉穿刺中心静脉置管（PICC）在化疗给药方面的不同临床效果和不良反应进行比较。哪种更好尚无定论。因此，开展本研究以评估这两种最佳血管通路策略的安全性和有效性。

方法

检索了以下电子数据库：PubMed、Embase以及2023年5月更新的Cochrane图书馆。纳入了关于使用PICC或PORT进行化疗的癌症患者并发症发生率差异的研究。使用Meta分析Revman 5.3软件进行统计分析。

结果

共检索到22篇文章。结果表明，PORT具有更好的安全性，总体不良反应（OR=2.72，95%CI=1.56-4.72，P=0.0004）、导管相关血栓形成（OR=2.84，95%CI=1.97-4.11，P<0.00001）和过敏反应（OR=6.26，95%CI=1.86-21.09，P=0.003）的发生率低于PICC通常预期的发生率。此外，在深静脉血栓形成（DVT）（OR=2.00，95%CI=0.86-4.65，P=0.11）和感染（OR=1.55，95%CI=0.75-3.22，P=0.24）方面，PICC不劣于PORT组。