延长维护间隔时间对非治疗期患者输液港并发症影响的Meta分析

doi:10.3761/j.issn.0254-1769.2022.05.004

摘要/Abstract

摘要：

目的评价延长维护间隔时间对非治疗期患者输液港相关并发症的影响。方法检索中国知网、维普数据库、万方数据库、中国生物医学文献数据库、PubMed、Cochrane Library、Embase、Web of Science数据库中关于延长非治疗期患者输液港维护间隔时间的文献,检索时限为建库至2021年10月6日。由2名研究者独立进行文献筛选、资料提取和质量评价后,采用RevMan 5.3软件进行统计分析。结果共纳入11篇文献,2 268例患者。Meta分析结果显示,维护间隔时间>4周与≤4周相比,导管相关并发症总发生率[RR=0.82,95%CI（0.56,1.19）,P=0.30]及导管堵塞发生率[RR=0.84,95%CI（0.54,1.31）,P=0.44]、导管相关性感染发生率[RR=1.47,95%CI（0.38,5.73）,P=0.58]差异均无统计学意义。描述性分析显示,延长维护间隔时间未增加血栓的发生率,并可减少输液港的维护费用。结论延长非治疗期患者输液港维护间隔时间是安全可行的,不会增加其并发症的发生率,并可减少输液港的维护费用。未来需要更多高质量的随机对照试验验证输液港最佳的维护间隔时间。

关键词: 完全植入式静脉输液港, 非治疗期, 维护, 并发症, Meta分析, 护理

Abstract:

Objective To evaluate the effect of prolonging the maintenance interval for totally implantable venous access ports on complications in patients during the period of non-treatment by meta-analysis. Methods We searched CNKI,VIP,Wanfang,CBM,PubMed,Cochrane Library,Embase and Web of Science databases for publications that examined the effect of prolonging the maintenance interval during the period of non-treatment from the inception of databases to October 6,2021. 2 reviewers independently conducted the literature screening,data extraction and quality assessment. Meta-analysis was then performed by RevMan 5.3 software. Results A total of 11 publications including 2 268 patients were included. The meta-analysis showed that compared with the intervals less than 4 weeks,there were no statistically significant differences in the incidence of catheter-related total complications[RR=0.82,95%CI（0.56,1.19）,P=0.30],occlusion[RR=0.84,95%CI（0.54,1.31）,P=0.44] or infection[RR=1.47,95%CI（0.38,5.73）,P=0.58] for the intervals longer than 4 weeks. Descriptive analysis indicated that prolonging the maintenance interval did not increase the incidence of thrombosis,but significantly reduced maintenance costs. Conclusion Prolonging the maintenance interval of totally implantable venous access ports is safe and feasible without increased incidence of complications,which can reduce economic costs. More high-quality randomized controlled trials are needed for verification of the optimal maintenance interval.

Key words: Totally Implantable Venous Access Port, Period of Non-Treatment, Maintenance, Complications, Meta-Analysis, Nursing Care

汪惜凤, 鞠阳, 杨益群. 延长维护间隔时间对非治疗期患者输液港并发症影响的Meta分析[J]. 中华护理杂志, 2022, 57(5): 536-543.

WANG Xifeng, JU Yang, YANG Yiqun. Effect of prolonging the maintenance interval for totally implantable venous access ports on complications in patients during the period of non-treatment：a meta-analysis[J]. Chinese Journal of Nursing, 2022, 57(5): 536-543.

图/表 5

图1 文献筛选流程图

Figure 1 Flow chart of literature screening

表1 纳入文献的基本特征（n=11）

Table 1 Baisc characteristics of the included studies（n=11）

表2 随机对照试验方法学质量评价结果（n=4）

Table 2 Risk of bias assesment for randomized controlled trials（n=4）

图2 维护间隔时间>4周对非治疗期患者导管相关并发症总发生率的影响注：试验组的干预措施为输液港维护间隔时间>4周,对照组为≤4周。

Figure 2 Effect of maintenance intervals longer than 4 weeks on the overall incidence of catheter-related complications in patients during the period of non-treatment

表3 队列研究方法学质量评价结果（n=7）

Table 3 Risk of bias assesment for cohort study（n=7）

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