置管部位对我国血液病患者PICC相关性血栓影响的meta分析

Meta-analysis of the impact of catheterization sites on PICC-related thrombosis in Chinese patients with hematological diseases

目的系统评价置管部位对我国血液病患者经外周静脉置入中心静脉导管术后相关性血栓的影响,为临床提供借鉴依据。方法检索中英文数据库,时限为2001年1月1日至2023年1月1日,将检索的文献交由2名专业人员筛选与评价,最终纳入的文献采用Review Manager 5.3进行meta分析。结果共纳入9篇文献,总累计病例组188例、对照组1340例,涉及4项影响因素。meta分析结果显示:贵要静脉[OR=0.63,95%CI(0.43,0.94)、P=0.02]、头静脉[OR=2.45,95%CI(1.39,4.34),P=0.002]、置管肢体[OR=0.63,95%CI(0.41,0.96),P=0.03]同其他比较,差异有统计学意义(P<0.05)。结论贵要静脉、左侧置管可降低我国血液病患者导管相关性血栓的发生率,为保护因素;头静脉及右侧置管为危险因素。

Objective To systematically evaluate the impact of catheterization sites on related thrombosis in Chinese patients with hematological diseases after peripherally inserted central catheter,and to provide a reference for clinical practice.Methods The Chinese and English databases were retrieved,with the retrieval duration from January 1,2001 to January 1,2023.The retrieved literature was screened and evaluated by two professionals,and a meta-analysis was conducted on the final included literature using Review Manager 5.3.Results A total of 9 articles were included,with a total of 188 patients in the case group and 1340 patients in the control group,involving 4 influencing factors.The meta-analysis results showed that the basilic vein(OR=0.63,95%CI[0.43,0.94],P=0.02),cephalic vein(OR=2.45,95%CI[1.39,4.34],P=0.002),and the limb for catheterization(OR=0.63,95%CI[0.41,0.96],P=0.03)showed statistically significant difference(P<0.05).Conclusion The basilic vein and left catheterization can reduce the incidence of PICC-related VT in patients with hematological diseases in China,being protective factors.The cephalic vein and right catheterization are risk factors.