肿瘤患者PICC血流感染影响因素的Meta分析

Meta-analysis of influencing factors of PICC blood flow infection in tumor patients

目的探讨肿瘤患者经外周中心静脉置管(PICC)血流感染的影响因素,为肿瘤患者PICC血流感染预防控制提供理论支持。方法主题词和关键词结合,计算机检索PubMed、Embase、Cochrane Library、Web of Science、中国知网(CNKI)、中国生物医学文献数据库(CBM)、万方数据知识服务平台(WANFANG)、维普中国科技期刊数据库(VIP)等数据库,搜集关于肿瘤患者PICC血流感染因素相关研究,检索时限为各大数据库建库至2019年11月25号。采用Review Manager 5.3对纳入文献进行Meta分析,采用Stata 11做发表偏倚分析。结果本研究共纳入文献39篇,23个因素,Meta分析结果显示:年龄、男性、操作者经验少、头股静脉、未按时维护、更换敷贴天数、穿刺次数>2次、夏冬季置管、置管时间长、其他材料、导管移动、化疗疗程>6个、维护知识少、合并并发症、白细胞计数异常、化疗次数>3次、肿瘤中晚期、应用激素、静脉高营养、抗菌药物与肿瘤患者PICC血流感染有关;穿刺方式、住院时间长及文化程度高与肿瘤患者PICC血液感染无关。结论为防止PICC置管的肿瘤病人发生感染,临床医务人员应在工作过程中,应加大对高危人群的监测,并制定相应的预防措施。

Objective To investigate the influencing factors of blood flow infection through peripherally inserted central catheter(PICC)in tumor patients,so as to provide theoretical support for the prevention and control of PICC blood flow infection in tumor patients.Methods Subject terms and keywords were searched to retrieve PubMed,Embase,Cochrane Library,Web of Science,CNKI,CBM,WANFANG Data Knowledge Service Platform,VIP and other databases,so as to collect relevant studies on factors of PICC blood flow infection in tumor patients.The collected data covers from the establishment of major databases to November 25,2019.Review Manager 5.3 was used for Meta-analysis of the included literature,and Stata 11 was used for analysis of publication bias.Results A total of 39 references were included in this study,including 23 factors.Meta-analysis results showed that the following factors were associated with PICC blood flow infection in tumor patients:age,male,inexperienced operator,head femoral vein,overdue maintenance and the number of days to replace application,puncture times more than 2,catheterization in summer and winter,long catheterization time,other materials,catheter mobile,chemotherapy courses>6 times,less maintenance knowledge,associated complications,abnormal white blood cell count,chemotherapy>3 times,advanced tumor,hormone application,venous hypernutrition,antimicrobial agents.The puncture method,long hospital stay and high educational level were not associated with PICC blood infection in tumor patients.Conclusion In order to prevent the infection of tumor patients with PICC,clinical medical staff should enhance the monitoring of high-risk patients and develop corresponding preventive measures.