国内成人肿瘤患者PICC相关性血栓发生率的Meta分析

Incidence of peripherally inserted central catheter-related thrombosis in Chinese adult cancer patients:a meta-analysis

目的系统评价国内成人肿瘤患者PICC相关性血栓的发生率。方法计算机检索PubMed、Embase、The Cochrane Library、Web of Science、中国生物医学文献数据库、中国知网、万方数据库和维普数据库,收集关于国内成人肿瘤患者PICC相关性血栓发生率的文献,检索时限为建库至2021年5月。2名研究者独立筛选文献、提取资料并评价纳入文献的偏倚风险后,采用Stata 14.0软件进行Meta分析。结果共纳入23篇文献,包括15066例肿瘤患者。Meta分析结果显示,国内成人肿瘤患者PICC相关性血栓的发生率为8.82%[95%CI(5.93%~12.18%)]。亚组分析结果显示,发表年份为2019年—2021年的文献、年龄≥60岁、BMI>25、穿刺静脉为头静脉、穿刺方法为传统方法、穿刺次数>1次、导管规格为5 Fr、肺癌、肿瘤分期为Ⅲ~Ⅳ期、合并糖尿病、有PICC置管史、有静脉血栓史、置管前纤维蛋白原≥4 g/L、置管前D-二聚体≥0.5 mg/L的患者PICC相关性血栓发生率更高。结论成人肿瘤患者PICC相关性血栓的发生率较高,医护人员应重视高危患者的早期筛查和相关预防工作。

Objective To systematically review the incidence of peripherally inserted central catheter(PICC)-related thrombosis in Chinese adult cancer patients.Methods PubMed,Embase,the Cochrane Library,Web of Science,CBM,CNKI,WanFang Data and VIP databases were electronically searched to collect studies on the incidence of PICC-related thrombosis in Chinese adult cancer patients from inception to May,2021.2 reviewers independently screened the literature,extracted the data and assessed the risk of bias of included studies,and then the meta-analysis was performed by Stata 14.0 software.Results A total of 23 pieces of the literature involving 15066 cancer patients were included.Meta-analysis results showed that the total incidence of PICC-related thrombosis in Chinese adult cancer patients was 8.82%[95%CI(5.93%~12.18%)].Subgroup analysis showed that the incidence of PICC-related thrombosis was higher in the publication year from 2019 to 2021.The incidence was also higher in patients with age≥60 years old,BMI>25,cephalic vein puncture,traditional puncture method,the number of punctures more than 1,catheter size of 5 Fr,lung cancer,cancer stage ofⅢ~Ⅳ,diabetes mellitus,history of PICC catheterization,history of venous thrombosis,fibrinogen content≥4 g/L before catheterization and D-dimer level≥0.5 mg/L before catheterization.Conclusions The incidence of PICC-related thrombosis in Chinese adult cancer patients is high,so health workers should pay more attention to early screening and prevention of high-risk patients.