胸部X线片定位联合体表测量预测经外周静脉置入中心静脉导管置管长度的Meta分析

Meta-Analysis on Chest Radiography Positioning Combined with Body Surface Measurement in Predicting Peripherally Inserted Central Venous Catheter Length

目的:分析胸部X线片定位联合体表测量预测经外周静脉置入中心静脉导管(PICC)置管长度的效果。方法:通过检索中英文数据库建库至2024年3月23日关于PICC导管体表测量、胸部X线片定位的文献。统计纳入文献的基本特征,评价文献质量和发表偏倚,分析PICC胸部X线片定位联合体表测量预测导管尖端的准确率。结果:共纳入15篇文献,总样本量为3 031例,观察组(胸部X线片定位联合体表测量)1 410例,对照组(体表测量)1 621例。经纽卡斯尔-渥太华量表评价文献质量总体较高,研究病例基本资料无差异,观察组与对照组具有可比性,7篇高质量文献(评分9分),8篇文献(评分8分),可能存在记录及执行者偏移风险,分析结果可靠,模型稳定。所有文献无明显发表偏倚,观察组导管尖端位置预测的准确率高于对照组(P<0.001)。结论:胸部X线片定位联合体表测量在预测PICC导管置管长度中的应用价值较高,能够提高PICC导管尖端位置预测的准确率,值得临床推广并予以应用。

Objective:To analyze the effect of chest radiography positioning combined with body surface measurement in predicting peripherally inserted central venous catheter(PICC)length.Methods:Chinese and English databases were retrieved for the literatures on PICC body surface measurement and chest radiography positioning from the establishment of the database to March 23,2024.The basic characteristics of the included literature were statistically analyzed,the literature quality and the publication bias were evaluated,and the accuracy of chest radiography positioning combined with body surface measurements in predicting the PICC catheter tip was analyzed.Results:A total of 15 literatures were included,with a total sample size of 3031 cases,including 1410 cases in the observation group(chest radiography positioning combined with body surface measurement)and 1621 cases in the control group(body surface measurement).The literature quality evaluated by the Newcastle-Ottawa scale was generally high.There was no difference in the basic data of the study cases,which were comparable between the observation group and the control group.There were 7 high-quality literatures(scored 9 points)and 8 literatures(scored 8 points)with a potential risk of record and executor deviation.The analysis results were reliable,and the model was stable.There was no significant publication bias in all literatures,and the accuracy of predicting the catheter tip position in the observation group was higher than that in the control group(P<0.001).Conclusion:Chest radiography positioning combined with body surface measurement has high application value in predicting the length of PICC catheterization,and can improve the accuracy of predicting the PICC catheter tip position,and is worthy of clinical promotion and application.