中华护理杂志 ›› 2024, Vol. 59 ›› Issue (4): 416-524.DOI: 10.3761/j.issn.0254-1769.2024.04.005
贺文静(), 王丹丹, 王文, 杨旭红, 沈犁, 赵文静()
收稿日期:
2023-03-30
出版日期:
2024-02-20
发布日期:
2024-02-22
通讯作者:
赵文静,E-mail:Zwja00186@btch.edu.cn作者简介:
贺文静:女,本科,主管护师,重症监护室督导,E-mail:hewenjing@btch.edu.cn
HE Wenjing(), WANG Dandan, WANG Wen, YANG Xuhong, SHEN Li, ZHAO Wenjing()
Received:
2023-03-30
Online:
2024-02-20
Published:
2024-02-22
摘要:
目的 比较中长导管和PICC在导管相关性静脉血栓发生率的差异。 方法 检索中国知网、万方数据库、维普数据库、Web of Science、PubMed、Embase、Cochrane Library中关于患者应用中长导管与PICC导管相关性静脉血栓发生率的随机对照试验、队列研究,检索时限为建库至2022年12月31日。使用Review Manager 5.4软件和Stata 14.0软件对结局指标进行Meta分析与描述。 结果 共纳入16项研究,队列研究12项,随机对照研究4项,包括21 853例研究对象。Meta分析结果显示,中长导管、PICC的每千导管日的导管相关性静脉血栓发生率比较,差异具有统计学意义[RR=2.74,95%CI(1.21,6.21),P=0.016];中长导管、PICC的导管相关性静脉血栓发生率比较,差异无统计学意义[RR=0.85,95%CI=(0.70,1.03),P=0.101]。在亚组分析中,中长导管、PICC的浅静脉血栓发生率比较,差异具有统计学意义[RR=2.36,95%CI=(1.56,3.58),P<0.001]。 结论 中长导管的导管相关性静脉血栓发生率高于PICC。故在临床实践中,应合理选择血管通装置,重视导管相关性静脉血栓的发生和发展,在充分评估的基础上有效开展临床筛查。
贺文静, 王丹丹, 王文, 杨旭红, 沈犁, 赵文静. 中长导管与PICC导管相关性静脉血栓发生率比较的Meta分析[J]. 中华护理杂志, 2024, 59(4): 416-524.
HE Wenjing, WANG Dandan, WANG Wen, YANG Xuhong, SHEN Li, ZHAO Wenjing. Common incidence of catheter-related venous thrombosis between midline catheter and peripherally inserted central catheter:a Meta-analysis[J]. Chinese Journal of Nursing, 2024, 59(4): 416-524.
图4 2种静脉血管通路装置的每千导管日导管相关性静脉血栓发生率Meta分析森林图
Figure 4 Forest plot of the incidence of CRVT per thousand catheter days in a meta-analysis of 2 types of venous access devices
[1] | Presley B, Isenberg JD. Ultrasound guided intravenous access[M]. Statpearls. Treasure Island(FL): StatPearls Publishing Copyright, 2023. |
[2] | 国家统计局. 中国统计年鉴[M]. 北京: 中国统计出版社, 2022. |
National Bureau of Statistics of China. China statistical yearbook[M]. Beijing: China Statistics Press, 2022. | |
[3] | 王栋, 罗平, 刘韶, 等. 住院患者静脉输液专项管理实践[J]. 中国卫生质量管理, 2022, 29(5):34-37. |
Wang D, Luo P, Liu S, et al. Special management practice of intravenous infusion for inpatients[J]. Chin Health Qual Manag, 2022, 29(5):34-37. | |
[4] |
Kuang Z, Liu X, Zhu Y, et al. A retrospective cohort study of disease-related risk factors for central venous catheter-related symptomatic thrombosis in intensive care unit inpatients[J]. Medicine, 2021, 100(29):e26732.
DOI URL |
[5] |
吴文瑾, 徐亦虹, 柳小琳, 等. 中心静脉置管患者导管相关性血栓风险预测模型的系统评价[J]. 中华护理杂志, 2022, 57(23):2834-2842.
DOI |
Wu WJ, Xu YH, Liu XL, et al. Systematic review of risk pre-diction models for catheter-related thrombosis in patients undergoing central venous catheterization[J]. Chin J Nurs, 2022, 57(23):2834-2842. | |
[6] | 李慧妍, 邵群, 张志仁. 导管相关性血栓研究进展[J]. 肿瘤综合治疗电子杂志, 2019, 5(3):8-12. |
Li HY, Shao Q, Zhang ZR. Progress of catheter-related thrombosis[J]. J Multidiscip Cancer Manag, 2019, 5(3):8-12. | |
[7] |
李乾, 赵欣, 张晓维, 等. 国内成人肿瘤患者PICC相关性血栓发生率的Meta分析[J]. 中华护理杂志, 2022, 57(3):348-355.
DOI |
Li Q, Zhao X, Zhang XW, et al. Incidence of peripherally inserted central catheter-related thrombosis in Chinese adult cancer patients:a meta-analysis[J]. Chin J Nurs, 2022, 57(3):348-355. | |
[8] |
赵林芳, 蔡志云, 樊小朋, 等. 中等长度静脉导管置管不同尖端位置的效果比较[J]. 中华护理杂志, 2022, 57(5):517-524.
DOI |
Zhao LF, Cai ZY, Fan XP, et al. Application comparison of different tip positions of midline catheters[J]. Chin J Nurs, 2022, 57(5):517-524.
DOI |
|
[9] |
Lescinskas EH, Trautner BW, Saint S, et al. Use of and patient-reported complications related to midline catheters and peripherally inserted central catheters[J]. Infect Control Hosp Epidemiol, 2020, 41(5):608-610.
DOI URL |
[10] |
Bing S, Smotherman C, Rodriguez RG, et al. PICC versus midlines:comparison of peripherally inserted central catheters and midline catheters with respect to incidence of thromboembolic and infectious complications[J]. Am J Surg, 2022, 223(5):983-987.
DOI URL |
[11] | Higgins JP, Altman DG, Gøtzsche PC, et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials[J]. BMJ(Clinical research ed), 2011, 343:d5928. |
[12] |
Stang A. Critical evaluation of the Newcastle-Ottawa Scale for the assessment of the quality of nonrandomized studies in meta-analyses[J]. Eur J Epidemiol, 2010, 25(9):603-605.
DOI PMID |
[13] | Bahl A, Karabon P, Chu D. Comparison of venous thrombosis complications in midlines versus peripherally inserted central catheters:are midlines the safer option?[J]. Clin Appl Thromb Hemost, 2019, 25:1076029619839150. |
[14] |
Caparas JV, Hu JP. Safe administration of vancomycin through a novel midline catheter:a randomized,prospective clinical trial[J]. J Vasc Access, 2014, 15(4):251-256.
DOI PMID |
[15] | Lisova K, Paulinova V, Zemanova K, et al. Experiences of the first PICC team in the czech republic[J]. Br J Nurs, 2015, 24(2):S4,s6,s10. |
[16] |
Sebolt J, Buchinger J, Govindan S, et al. Patterns of vascular access device use and thrombosis outcomes in patients with COVID-19:a pilot Multi-site study of Michigan hospitals[J]. J Thromb Thrombolysis, 2022, 53(2):257-263.
DOI |
[17] |
Seo H, Altshuler D, Dubrovskaya Y, et al. The safety of midline catheters for intravenous therapy at a large academic medical center[J]. Ann Pharmacother, 2020, 54(3):232-238.
DOI PMID |
[18] |
Sharp R, Esterman A, McCutcheon H, et al. The safety and efficacy of midlines compared to peripherally inserted central catheters for adult cystic fibrosis patients:a retrospective,observational study[J]. Int J Nurs Stud, 2014, 51(5):694-702.
DOI URL |
[19] |
Swaminathan L, Flanders S, Horowitz J, et al. Safety and outcomes of midline catheters vs peripherally inserted central catheters for patients with short-term indications:a multicenter study[J]. JAMA Intern Med, 2022, 182(1):50-58.
DOI URL |
[20] |
Tao F, Wang X, Liu J, et al. Perioperative application of midline catheter and PICC in patients with gastrointestinal tumors[J]. J BUON, 2019, 24(6):2546-2552.
PMID |
[21] |
Tso AR, Patniyot IR, Gelfand AA, et al. Increased rate of venous thrombosis may be associated with inpatient dihydroergotamine treatment[J]. Neurology, 2017, 89(3):279-283.
DOI PMID |
[22] |
Xu T, Kingsley L, DiNucci S, et al. Safety and utilization of peripherally inserted central catheters versus midline catheters at a large academic medical center[J]. Am J Infect Control, 2016, 44(12):1458-1461.
DOI PMID |
[23] |
Zerla PA, Canelli A, Caravella G, et al. Open-vs closed-tip valved peripherally inserted central catheters and midlines:findings from a vascular access database[J]. JAVA, 2015, 20(3):169-176.
DOI URL |
[24] | 吕朋, 王媛媛, 杨立军, 等. 高龄肿瘤患者主动静脉治疗时应用不同血管通路装置输注发疱剂的安全效果[J]. 河北医药, 2021, 43(22):3448-3451. |
Lü P, Wang YY, Yang LJ, et al. The safety effect of bleb infusion through different vascular access devices in active vein therapy for elderly patients with neoplasm[J]. Hebei Med J, 2021, 43(22):3448-3451. | |
[25] | 朱颖, 赵燕, 周燕妮, 等. 外周中等长度导管在神经外科患者中的应用效果[J]. 实用临床医药杂志, 2021, 25(2):40-42,58. |
Zhu Y, Zhao Y, Zhou YN, et al. Effect of peripheral medium length catheter applied in neurosurgical patients[J]. J Clin Med Pract, 2021, 25(2):40-42,58. | |
[26] | 车肖文, 唐晓莲, 颜婧. 晚期肿瘤静脉营养支持患者应用改良型中等长度导管与PICC效果比较[J]. 临床与病理杂志, 2020, 40(9):2341-2344. |
Che XW, Tang XL, Yan J. Comparison of the effects of modi-fied midline catheter and PICC in patients with advanced tumor intravenous nutrition support[J]. J Clin Pathol Res, 2020, 40(9):2341-2344. | |
[27] | Moureau N, Chopra V. Indications for peripheral,midline and central catheters:summary of the magic recommendations[J]. Br J Nurs, 2016, 25(8):S15-24. |
[28] | Pittiruti M, Scoppettuolo G. The GAVeCeLT manual of PICC and midline:indications,insertion,management[M]. Florida: Edra Publishing, 2017. |
[29] | 张星霞, 胡艳杰, 李卡. 经外周静脉穿刺置入中心静脉导管留置时间研究现状[J]. 护理研究, 2021, 35(11):1947-1950. |
Zhang XX, Hu YJ, Li K. Status quo of indwelling time of peripherally inserted central venous catheters[J]. Chin Nurs Res, 2021, 35(11):1947-1950. | |
[30] |
Tripathi S, Kumar S, Kaushik S. The practice and complications of midline catheters:a systematic review[J]. Crit Care Med, 2021, 49(2):e140-e150.
DOI PMID |
[31] |
Evans NS, Ratchford EV. Catheter-related venous thrombosis[J]. Vasc Med, 2018, 23(4):411-413.
DOI PMID |
[32] |
Cosmi B. Management of superficial vein thrombosis[J]. J Thromb Haemost, 2015, 13(7):1175-1183.
DOI PMID |
[33] |
Chen P, Zhu B, Wan G, et al. The incidence of asymptomatic thrombosis related to peripherally inserted central catheter in adults:a systematic review and meta-analysis[J]. Nurs Open, 2021, 8(5):2249-2261.
DOI URL |
[34] |
Decousus H, Quéré I, Presles E, et al. Superficial venous thrombosis and venous thromboembolism:a large,prospective epidemiologic study[J]. Ann Intern Med, 2010, 152(4):218-224.
DOI PMID |
[35] |
Citla Sridhar D, Abou-Ismail MY, Ahuja SP. Central venous catheter-related thrombosis in children and adults[J]. Thromb Res, 2020, 187:103-112.
DOI PMID |
[36] |
Duijzer D, de Winter MA, Nijkeuter M, et al. Upper extremity deep vein thrombosis and asymptomatic vein occlusion in patients with transvenous leads:a systematic review and meta-analysis[J]. Front Cardiovasc Med, 2021, 8:698336.
DOI URL |
[37] |
Skulec R, Kohlova A, Miksova L, et al. The reliability of ultrasound compression test performed by general ICU nurses in the critically ill patients:a preliminary prospective clinical study[J]. Eur J Intern Med, 2020, 76:130-131.
DOI PMID |
[38] | Schafer K, Goldschmidt E, Oostra D, et al. Defining the role of risk stratification and duplex ultrasound in the diagnosis of acute lower extremity deep vein thrombosis[J]. J Vasc Surg Venous Lymphat Disord, 2022, 10(5):1021-1027. |
[39] |
Gornik HL, Gerhard-Herman MD, Misra S, et al. ACCF/ACR/AIUM/ASE/IAC/SCAI/SCVS/SIR/SVM/SVS/SVU 2013 appropriate use criteria for peripheral vascular ultrasound and physiological testing part ii:testing for venous disease and evaluation of hemodialysis access:a report of the American college of cardiology foundation appropriate use criteria task force[J]. J Am Coll Cardiol, 2013, 62(7):649-665.
DOI URL |
[1] | 项小燕, 朱薇, 钦晓英, 黄培培, 卢琪, 张烨, 崔智萍. 超声斜轴平面引导技术在PICC穿刺术中的应用研究[J]. 中华护理杂志, 2024, 59(4): 389-394. |
[2] | 贾秀芬, 刘玉平, 龙淑红, 王锦, 孟冉, 姜晓丽. 钝性分离送鞘技术在凝血功能障碍老年患者中长导管置管中的应用研究[J]. 中华护理杂志, 2024, 59(4): 395-400. |
[3] | 杨小惠, 刘畅, 于卫华, 陈炯煌, 盛婉婷, 曹秀珠, 曾旭芬, 金向红, 赵林芳. 不同长度外周静脉导管在减重手术患者围手术期的应用效果评价[J]. 中华护理杂志, 2024, 59(4): 401-407. |
[4] | 刘广欣, 孙霞, 刘莉, 李卫峰. 迷你中长导管留置与维护的最佳证据总结[J]. 中华护理杂志, 2024, 59(4): 408-415. |
[5] | 刘建萍, 郭卫婷, 高伟, 王文君, 盛源, 范春梅, 鲁琦, 刘德山. 心脏康复患者运动恐惧体验质性研究的Meta整合[J]. 中华护理杂志, 2024, 59(4): 474-481. |
[6] | 应钰皑, 孙蕊, 胡晨, 王耀伦, 周兰兰, 胡宏鸯. 运动锻炼对帕金森病患者睡眠质量影响的Meta分析[J]. 中华护理杂志, 2024, 59(4): 482-489. |
[7] | 吴前胜, 曾莹, 王兰, 王萧萧, 周雁荣. 体外循环下心脏手术患者术后谵妄管理的循证实践[J]. 中华护理杂志, 2024, 59(3): 292-299. |
[8] | 张若萱, 赵健, 牟利宁. 钠-葡萄糖共转运蛋白2抑制剂导致酮症酸中毒的Meta分析及护理对策[J]. 中华护理杂志, 2024, 59(3): 353-361. |
[9] | 冯琦凡, 涂发妹, 吴季敏, 刘萍萍, 刘佳晨, 张思易, 张鑫. 烧伤患者身体意象体验质性研究的Meta整合[J]. 中华护理杂志, 2024, 59(3): 362-370. |
[10] | 朱东阁, 王菊子, 赵倩, 何亚鹏, 张转转, 杨雨桐. 维持性血液透析患者透析中低血压风险预测模型的系统评价[J]. 中华护理杂志, 2024, 59(2): 174-183. |
[11] | 季谋芳, 李若冰, 胡廷进, 陈静怡. 不同非药物干预方式对产后抑郁症患者影响的网状Meta分析[J]. 中华护理杂志, 2024, 59(2): 228-235. |
[12] | 台瑞, 方芳, 杨富, 余倩. 择期胃肠道手术患者预康复的最佳证据总结[J]. 中华护理杂志, 2024, 59(2): 236-243. |
[13] | 尹佳宁, 管晓敏, 贾登帅, 徐玲, 陈兰. ICU机械通气患者撤机后呼吸肌训练的最佳证据总结[J]. 中华护理杂志, 2024, 59(1): 33-41. |
[14] | 韩娜菲, 冯华丽, 贺红, 李茜, 徐剑锋, 金尧娟, 沈孟雅, 孙佳烨, 黄天海. 肺癌合并慢性阻塞性肺疾病患者术后肺康复管理的证据总结[J]. 中华护理杂志, 2024, 59(1): 42-49. |
[15] | 许志玮, 王娴, 穆文方, 王燕, 王安子. 下肢静脉溃疡患者体力活动的最佳证据总结[J]. 中华护理杂志, 2024, 59(1): 100-107. |
阅读次数 | ||||||
全文 |
|
|||||
摘要 |
|
|||||