化疗癌症患者经隧道式和非隧道式外周静脉穿刺中心静脉置管的并发症：一项荟萃分析。

Complications of tunneled and non-tunneled peripherally inserted central catheter placement in chemotherapy-treated cancer patients: a meta-analysis.

作者信息

Hong Jiana, Mao Xiaodan

机构信息

Department of Medical Oncology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), Hangzhou, Zhejiang, China.

出版信息

Front Surg. 2024 Oct 15;11:1469847. doi: 10.3389/fsurg.2024.1469847. eCollection 2024.

BACKGROUND

Tunneled peripherally inserted central catheters (PICC) have potential to reduce complications compared to non-tunneled PICC in previous studies. Which is better is debatable. Thus, the aim to compare the effect of tunneled and non-tunneled PICC for cancer patients undergoing chemotherapy.

METHODS

Embase, PubMed, Cochrane Library database, and CNKI were searched from inception to March 15, 2024. Odds ratios (ORs) with 95% confidence intervals (95% CIs) was calculated to assess the complications of tunneled and non-tunneled PICC for cancer patients undergoing chemotherapy using random- or fixed-effects models.

RESULTS

A total of 12 articles were retrieved. Meta-analysis showed that tunneled PICC significantly decreased the risk of wound oozing (OR: 0.29, 95% CI: 0.20-0.41), infection risk (OR: 0.41, 95% CI: 0.20-0.85), thrombosis risk (OR: 0.26, 95% CI: 0.15-0.44), phlebitis risk (OR: 0.23, 95% CI: 0.13-0.40), and catheter dislodgement risk (OR: 0.33, 95% CI: 0.22-0.50) compared to non-tunneled PICC.

CONCLUSIONS

The subcutaneous tunneling technology has advantages over normal technique in decreasing PICC-related complications for cancer patients undergoing chemotherapy.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO (CRD42024522862).

背景

在以往研究中，隧道式经外周静脉穿刺中心静脉导管（PICC）与非隧道式PICC相比，有降低并发症的潜力。哪种更好存在争议。因此，本研究旨在比较隧道式和非隧道式PICC对接受化疗的癌症患者的效果。

方法

检索了Embase、PubMed、Cochrane图书馆数据库和中国知网，检索时间从建库至2024年3月15日。采用随机效应模型或固定效应模型计算比值比（OR）及95%置信区间（95%CI），以评估隧道式和非隧道式PICC用于接受化疗的癌症患者的并发症情况。

结果

共检索到12篇文章。荟萃分析显示，与非隧道式PICC相比，隧道式PICC显著降低了伤口渗血风险（OR：0.29，95%CI：0.20 - 0.41）、感染风险（OR：0.41，95%CI：0.20 - 0.85）、血栓形成风险（OR：0.26，95%CI：0.15 - 0.44）、静脉炎风险（OR：0.23，95%CI：0.13 - 0.40）和导管移位风险（OR：0.33，95%CI：0.22 - 0.50）。