肿瘤患者植入式静脉输液港相关血流感染危险因素的Meta分析

Risk factors of implantable venous access port-related bloodstream infections in cancer patients:a Meta-analysis

目的系统评价肿瘤患者植入式静脉输液港导管相关血流感染的危险因素,为预防导管相关血流感染提供依据。方法检索Cochrane Library、PubMed、Embase、Web of Science、中国知网数据库、万方数据库、维普数据库、中国生物医学文献数据库、临床试验注册中心,搜集建库至2022年4月关于肿瘤患者植入式静脉输液港发生导管相关性血流感染危险因素的文献,2名评价者按照纳入与排除标准对所获文献独立进行文献筛选、资料提取,采用纽卡斯尔-渥太华量表进行质量评价,应用RevMan 5.3及Stata SE/MP(14.0版)软件进行Meta分析。结果共纳入13篇文献,包括23项暴露因素,其中导管使用时间长、姑息治疗、血液系统肿瘤、中性粒细胞减少、住院患者及化疗是肿瘤患者植入式静脉输液港相关血流感染的危险因素(OR值为0.26~8.78,均P<0.05)。结论导管使用时间长、姑息治疗、血液系统肿瘤、中性粒细胞减少、化疗是肿瘤患者植入式静脉输液港相关血流感染的危险因素,医务人员应做好评估,加强健康教育,使患者尽可能减少感染的机会,有效降低输液港相关感染的发生。

Objective To systematically evaluate the risk factors of implantable venous access port-related bloodstream infections and provide basis for prevention of catheter-related bloodstream infection in tumor patients.Methods The Cochrane Library,PubMed,EMBASE,Web of science,CNKI,Wanfang database,VIP database,CBM,Chinese and English Clinical trials Registry(ChiCTR)were searched to collect the literature on risk factors for implantable venous access port-related bloodstream infections in tumor patients from the establishment of the database to April 2022.Two evaluators independently screened and extracted the obtained literature according to the inclusion and exclusion criteria,and used the Newcastle-Ottawa Scale for quality evaluation.Meta-analysis was conducted by RevMan 5.3 software and Stata SE/MP(14.0 version).Results A total of 13 studies were included,including 23 related risk factors.Among them,prolonged use of catheters,palliative treatment,hematological tumors,neutropenia,hospitalized patients,and chemotherapy were risk factors for implantable venous access port-related bloodstream infections in tumor patients,with statistically significant differences(OR values ranging from 0.26 to 8.77,all P<0.05).Conclusions The long time of catheter use,palliative treatment,hematological tumor,neutropenia and chemotherapy were the risk factors of implantable venous access port-related bloodstream infection in patients with tumor,Medical personnel should make a good assessment and strengthen health education to minimize the chances of infection and effectively reduce the incidence of infection related to the infusion port.