深静脉PORT与PICC置管在肿瘤患者中的感染和血栓发生率的系统评价

Meta Analysis of Incidence of Infection and Thrombosis Between Deep Venous PORT and PICC in Tumor Patients

目的 系统评价植入式静脉输液港(implantable intravenous port,PORT)与经外周静脉置入中心静脉导管(peripherally inserted central venous catheter,PICC)置管后并发症的发生率,以期为肿瘤患者置管方案选择提供依据。方法 系统检索PubMed、Embase、SCI、CINHAL、Cochrane、中国生物医学文献服务系统(China Biomedical Literature Service,CBM)、中国知网(China National Knowledge Infrastructure,CNKI)、万方数据知识服务平台及维普网(VIP Net Work,VIP)等建库至2020年7月公开发表的随机对照研究,采用Rev Man 5.3进行Meta分析。结果 共纳入12篇文献,1 575例患者;Meta分析结果显示,PORT置管患者的感染发生率与PICC置管患者差异无统计学意义[RR=0.62,95%CI(0.26~1.47),P=0.28],PORT置管患者的血栓发生率明显低于PICC置管患者,差异有统计学意义[RR=0.24,95%CI(0.14~0.43),P <0.000 01]。结论 PORT置管患者术后感染发生率与PICC置管患者无明显差别,但PORT置管患者血栓并发症的发生率低于PICC置管患者。

Objective To systematically evaluate the incidence of complications between implantable intravenous port(PORT) and peripherally inserted central venous catheter(PICC).In order to provide a basis for the choice of catheterization program for cancer patients.Methods PubMed,Embase,SCI,CINHAL,Cochrane,China Biomedical Literature Service(CBM),China National Knowledge Infrastructure(CNKI),Wanfang Data Knowledge Service Platform and VIP Net Work(VIP) were systematically searched for randomized controlled studies published from the establishment of databases to July 2020.Rev Man 5.3 was used for meta-analysis.Results A total of 12 articles were included,including 1 575 patients.The results of meta-analysis showed that there was no significant difference in the incidence of infection between patients with PORT catheter and patients with PICC catheter [RR=0.62,95%CI(0.26-1.47),P=0.28].The incidence of thrombosis in patients with PORT catheter was significantly lower than that in patients with PICC catheter.The difference was statistically significant [RR=0.24,95%CI(0.14-0.43),P < 0.000 01].Conclusion There is no significant difference in the incidence of postoperative infection in PORT patients and PICC patients,but the incidence of thrombotic complications in PORT patients is lower than that of PICC patients.