本文選題：靜脈血栓形成　切入點(diǎn)：導(dǎo)管插入術(shù)　出處：《臨床薈萃》2017年02期 　論文類型：期刊論文

【摘要】：目的通過系統(tǒng)分析比較經(jīng)外周靜脈穿刺中心靜脈置管(peripherally inserted central catheters,PICCs)和其他中心靜脈置管(centralvenous catheters,CVCs)相關(guān)性靜脈血栓發(fā)生風(fēng)險。方法檢索PubMed數(shù)據(jù)庫、Cochrane臨床試驗(yàn)數(shù)據(jù)庫、中國知網(wǎng)(CNKI)、中國生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(CBM)和萬方數(shù)據(jù)庫,查找PICCs和CVCs相關(guān)靜脈血栓發(fā)生風(fēng)險的臨床對照研究。結(jié)果依納入標(biāo)準(zhǔn),共包含17個研究,6 299例患者。Meta分析結(jié)果顯示:與CVCs相比,PICCs置管靜脈血栓發(fā)生風(fēng)險升高(OR=2.785,95%CI=1.796~4.321,P0.01),亞組分析提示惡性腫瘤和重癥監(jiān)護(hù)患者靜脈血栓發(fā)生風(fēng)險均明顯升高(惡性腫瘤:OR=3.049,95%CI=1.949~4.770,P0.01;重癥監(jiān)護(hù):OR=3.954,95%CI=2.181~7.168,P0.01)。需治療人數(shù)(NNT)=-30,95%CI=-31.25~-27.78。漏斗圖及Egg檢驗(yàn)未見明顯發(fā)表偏倚,敏感性分析顯示結(jié)果穩(wěn)定。結(jié)論 PICCs高于CVCs相關(guān)性靜脈血栓的發(fā)生風(fēng)險,尤其對惡性腫瘤和重癥監(jiān)護(hù)患者,臨床應(yīng)加強(qiáng)PICCs使用者的血栓篩查。
[Abstract]:Objective to compare the risk of venous thrombosis associated with central inserted central catheterization via peripheral venous puncture and central venous catheterization (CVCs). Methods the PubMed database was searched for Cochrane clinical trials. CNKI, Chinese Biomedical Literature Database (CBM) and Wanfang database were used to find out the clinical controlled studies on the risk of venous thrombosis associated with PICCs and CVCs. A meta-analysis of 6 299 patients in 17 studies showed that compared with CVCs, the risk of venous thrombosis in patients with malignant tumor and in intensive care was significantly higher than that in patients with malignant tumor and intensive care, and the risk of venous thrombosis in patients with malignant neoplasms and intensive care was significantly higher than that in patients with malignant tumor and severe care (malignant tumor). The results of meta analysis showed that the risk of venous thrombosis in patients with malignant tumor and intensive care was significantly higher than that in patients with CVCs. The number of patients in need of treatment was 1.949 / 4.770 / P0.01. the number of patients in need of treatment was 2.181 / 7.168. no significant bias was found in funnel and Egg tests. Conclusion the risk of venous thrombosis associated with PICCs is higher than that of CVCs, especially in patients with malignant tumor and intensive care.
【作者單位】： 玉溪市人民醫(yī)院骨外二科;邯鄲市中醫(yī)院急診科;玉溪市人民醫(yī)院科教科;玉溪市人民醫(yī)院重癥醫(yī)學(xué)科;
【分類號】：R472.9

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