延长冲洗维护间隔对非治疗期植入式静脉输液港相关并发症影响的Meta分析

Effect of prolonging the maintenance interval of catheter flushing induced complications in totally implantable venous access port during non-treatment period:a Meta-analysis

目的评价延长冲洗维护间隔对非治疗期植入式静脉输液港(Totally implantable venous access ports,TIVAP)相关并发症的影响。方法计算机检索PubMed、Web of Science、Embase、Cochrane Library、中国知网、维普、万方数据库和中国生物医学文献数据库中关于非治疗期TIVAP不同冲洗维护间隔的队列研究、随机对照研究或高质量的病例对照研究。检索时限为各数据库建库起始至2020年9月。对满足纳入标准的文献使用RevMan 5.4软件对相关结局指标进行Meta分析。结果最终纳入研究10篇,其中队列研究6篇,随机对照研究4篇,共1703例患者。Meta分析结果显示,延长TIVAP冲洗维护间隔可以降低总并发症发生率[OR=0.60,95%CI(0.38,0.96),P=0.03]和堵管发生率[OR=0.58,95%CI(0.33,1.00),P=0.05],对感染发生率[OR=1.21,95%CI(0.41,3.62),P=0.73]无影响。结论目前证据表明,延长非治疗期TIVAP冲洗维护间隔不会增加总并发症发生率和堵管发生率,是一种可行的、安全的维护措施。

Objective To evaluate the effect of prolonged irrigation and maintenance interval on complications related to(Totally implantable venous access ports, TIVAP) during non-treatment period. Methods Cohort studies, randomized controlled studies or high-quality case-control studies were used by searching literatures in PubMed, Web of Science, Embase, Cochrane Library, CNKI, VIP, WanFang Database and China Biomedical Literature Database on different irrigation and maintenance intervals of TIVAP in non-treatment period. The retrieval time is from the beginning of the database construction until September 2020. Meta-analysiswas conducted by using RevMan 5.4 software. Ten studies were included, including 6 cohort studies and 4 randomized controlled studies, with a total of 1703 patients. The results of the Meta-analysis showed that extending the interval between TIVAP irrigation and maintenance could reduce the incidence of total complications [OR=0.60, 95%CI(0.38, 0.96), P=0.03]and the incidence of tube blockage[OR=0.58, 95%CI(0.33, 1.00), P=0.05], but had no effect on the incidence of infection[OR=1.21, 95%CI(0.41, 3.62), P=0.73]. Results This study included 10 studies, including 6 cohort studies and 4 randomized controlled studies, involving a total of 1703 patients. The results of the Meta-analysis showed that extending the interval between TIVAP irrigation and maintenance could reduce the incidence of total complications[OR=0.60, 95%CI(0.38, 0.96), P=0.03] and the incidence of tube blockage [OR=0.58, 95%CI(0.33, 1.00), P=0.05], but had no effect on the incidence of infection [OR=1.21, 95%CI(0.41,3.62), P=0.73]. Conclusion Prolong maintenance interval of TIVAP flushing during non-treatment period does not increase the incidence of total complications and tube blockage. It is a workable and safe maintenance measure.