JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES) ›› 2015, Vol. 53 ›› Issue (10): 73-81.doi: 10.6040/j.issn.1671-7554.0.2015.087

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A systematic review on the effects of venous access port and PICC in cancer patients undergoing chemotherapy

SUN Yuanyuan1,2, GAO Wei1, CUI Ying3, ZHANG Hong1, JIAO Jianfen1, LI Kan2, XU Ruicai2   

  1. 1. PICC Clinic, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China;
    2. School of Nursing, Shandong University, Jinan 250012, Shandong, China;
    3. Outpatient Clinic, Maternity and Child Health Care Hospital of Zouping County, Zouping 256200, Shandong, China
  • Received:2015-01-23 Online:2015-10-10 Published:2015-10-10

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Abstract: Objective To evaluate the effects of venous access port (VAP) and peripherally inserted central catheters (PICC) on cancer patients undergoing chemotherapy. Methods The relevant randomized controlled trials, quasi-randomized controlled trials and cohort studies on the comparison of PICC and VAP were searched in databases including Cochrane Library, Joanna Briggs Institute Library, MEDLINE, EMbase, Web of knowledge, CBM, CNKI, WanFang Data and VIP. Data obtained were extracted according to the inclusion and exclusion criteria by two reviewers independently. The quality of included studies was evaluated. A Meta-analysis was conducted using RevMan 5.3 software. Results Altogether 5 randomized controlled trials, 1 quasi-randomized controlled trial, and 16 cohort studies involving 3,278 patients were included. The results of Meta-analysis showed that VAP was associated with a significantly lower incidence of thrombosis and catheter-associated infection than PICC[RR=0.31, 95% CI(0.16, 0.59); RR=0.39, 95% CI (0.27, 0.57)]. However, the incidence of the stray into the artery and pneumothorax was higher than PICC[RR=8.70, 95% CI (1.61, 47.07); RR=6.12, 95% CI (1.41, 26.65)]. Patients' quality of life was higher afterVAP than PICC [RR=1.58, 95% CI (1.38, 1.82)]. The descriptive analysis showed that VAP had longer catheter indwelling time than PICC. Conclusion VAP has advantages in prolonging catheter indwelling time, decreasing the incidence of thrombosis and catheter-associated infection, and improving patients' quality of life. Therefore, it is worth to be promoted in clinical practice. However, to perform VAP, special attention should be paid to the adjacent anatomical relations of the puncture site during catheterization process, in order to reduce the incidence of pneumothorax and stray into the artery.

Key words: Venous access port, Neoplasms, Peripherally inserted central catheters, Systematic review, Meta-analysis

CLC Number: 

  • R472.9
[1] 唐鹏琳, 陈利芬, 成守珍, 等. 化疗患者应用PICC与植入式静脉输液港的比较[J]. 中国护理管理, 2014, 14(4):420-422. TANG Penglin, CHEN Lifen, CHENG Shouzhen, et al. The maintenance comparison of applying PICC and VPA among cancer patients undergoing chemotherapy[J]. Chinese Nursing Management, 2014, 14(4):420-422.
[2] Beckers MM, Ruven HJ, Seldenrijk CA, et al. Risk of thrombosis and infections of central venous catheters and totally implanted access ports in patients treated for cancer[J]. Thromb Res, 2010, 125(4):318-321.
[3] Higgins JP, Green S. Cochrane Handbook for Systematic Reviews of Interventions (Version 5.1.0)[EB/OL]. [2012-01-05]. http://www.cochrane-handbook.org.
[4] Wells G, Shea B, O'Connell D, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses[EB/OL]. [2012-06-15]. http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp.
[5] 胡雁, 李晓玲. 循证护理的理论与实践[M]. 上海:复旦大学出版社, 2007:30-40, 49, 74-78.
[6] 李红艳. 乳腺癌患者对 PICC 和静脉输液港满意度的比较与研究[J]. 世界最新医学信息文摘, 2014, 14(21):224.
[7] 王邓超, 林瑞娇, 张再重, 等. 植入式静脉输液港与外周静脉穿刺中心静脉置管在乳腺癌辅助化疗中的应用比较[J]. 中华内分泌外科杂志, 2014, 8(2):120-122. WANG Dengchao, LIN Ruijiao, ZHANG Zaizhong, et al. Comparison of venous port access and peripherally inserted central catheters in adjuvant chemotherapy for patients with breast cancer[J]. Chin J Endocr Surg, 2014, 8(2):120-122.
[8] 曾云菲, 罗丹丹. 比较PICC与植入式静脉输液港在白血病患者长期化疗中的应用评价[J]. 吉林医学, 2014, 35(23):5277.
[9] 郅丽, 高铭云, 黄小珍, 等. 超声实时引导 PICC 与植入式静脉输液港在肿瘤患者应用的比较[J].广西医学, 2014, 36(5):694-695.
[10] 郑明康, 陈辉. 外周静脉置入中心静脉导管与植入式静脉输液港在乳腺癌化疗中的应用[J]. 中国医药导报, 2014, 11(29):47-50. ZHENG Mingkang, CHEN Hui. Comparison of peripherally inserted central catheter and totally implantable venous access port in chemotherapy of breast cancer[J]. China Medical Herald, 2014, 11(29):47-50.
[11] 于瑞, 陈利芬, 唐鹏琳, 等. 不同中心静脉输液途径对乳腺癌患者置管并发症发生的影响[J]. 现代临床护理, 2014, 13(8):40-43. YU Rui, CHEN Lifen, TANG Penglin, et al. Effects of different approaches to central venous catheterization on complication incidence of breast tumor[J]. Modern Clinical Nursing, 2014, 13(8):40-43.
[12] 尹悦. PICC与VPA在肺癌患者化疗中的应用比较[J]. 江苏医药, 2014, 40(3):369-371.
[13] 张丽娟, 辛明珠, 张慧珍, 等. 乳腺癌病人留置PICC与VPA化疗的临床效果比较[J]. 护理研究, 2013, 27(18):1845-1846. ZHANG Lijuan, XIN Mingzhu, ZHANG Huizhen, et al. Comparison of clinical effects of indwelling PICC and VPA chemotherapy for patients with breast cancer[J]. Chinese Nursing Research, 2013, 27(18):1845-1846.
[14] 莫美珍, 林称喜, 钟华英, 等. 乳腺癌患者应用植入式静脉输液港与PICC的效果比较[J]. 中国实用护理杂志, 2013, 29(24):19-20.
[15] 潘小为, 侯秋秀, 罗金玲. 植入式静脉输液港与中心静脉导管降低感染的效果比较[J]. 中华医院感染学杂志, 2013, 23(14):3364-3365. PAN Xiaowei, HOU Qiuxiu, LUO Jinling. Comparison of effect between implanted venous port and PICC on decreasing infections[J]. Chin J Nosocomiol, 2013, 23(14):3364-3365.
[16] 何越, 孙艳萍, 李宁, 等. 血液恶性肿瘤患者应用PICC与植入式静脉输液港的效果比较[J]. 中华护理杂志, 2012, 47(11):1001-1003. HE Yue, SUN Yanping, LI Ning, et al. Comparison of the effects of PICC and venous access port in patients with hematological malignancies[J]. Chin J Nurs, 2012, 47(11):1001-1003.
[17] 倪霞, 张天华. PICC与VPA两种深静脉置管术在肺癌患者中的应用比较[J]. 浙江实用医学, 2011, 16(3):232-233.
[18] 郑雪贞. 植入式静脉输液港与PICC导管在白血病化疗中的应用比较[J]. 福建医药杂志, 2011, 33(4):175-176.
[19] 张学强. 植入式中心静脉输液港与经外周静脉中心静脉置管在恶性肿瘤患者中应用的对比研究[J]. 疑难病杂志, 2009, 8(9):553-554.
[20] 葛峰, 仓静, 薛张纲. 皮下埋藏式中心静脉导管应用于肿瘤化疗患者的临床效果[J]. 中华医学杂志, 2008, 88(33):2331-2334. GE Feng, CANG Jing, XUE Zhanggang. Safety and effectiveness of central vein catheters indwelling with subcutaneous port in patients undergoing chemotherapy[J]. Natl Med J China, 2008, 88(33):2331-2334.
[21] 马新娟, 张艳华, 郑卫红. PICC与VPA在白血病患者中的应用比较[J]. 护士进修杂志, 2008, 23(19):1807-1808.
[22] Patel GS, Jain K, Kumar R, et al. Comparison of peripherally inserted central venous catheters (PICC) versus subcutaneously implanted port-chamber catheters by complication and cost for patients receiving chemotherapy for non-haematological malignancies[J]. Support Care Cancer, 2014, 22(1):121-128.
[23] Cotogni P, Pittiruti M, Barbero C, et al. Catheter-related complications in cancer patients on home parenteral nutrition:a prospective study of over 51,000 catheter days[J]. JPEN J Parenter Enteral Nutr, 2013, 37(3):375-383.
[24] Bratton J, Johnstone PA, McMullen KP. Outpatient management of vascular access devices in children receiving radiotherapy:complications and morbidity[J]. Pediatr Blood Cancer, 2014, 61(3):499-501.
[25] Jain SA, Shukla SN, Talati SS, et al. A retrospective study of central venous catheters GCRI experience[J]. Indian J Med Paediatr Oncol, 2013, 34(4):238-241.
[26] Revel-Vilk S, Yacobovich J, Tamary H, et al. Risk factors for central venous catheter thrombotic complications in children and adolescents with cancer[J]. Cancer, 2010, 116(17):4197-4205.
[27] Kim HJ, Yun J, Kim HJ, et al. Safety and effectiveness of central venous catheterization in patients with cancer:prospective observational study[J]. J Korean Med Sci, 2010, 25(12):1748-1753.
[28] 江海云, 唐瑶. 失效模式效应分析在减少PICC非计划拔管中的应用[J]. 中国实用护理杂志, 2013, 29(18):63-65. JANG Haiyun, TANG Yao. Application of FMEA in reducing unplanned extubation of PICC[J]. Chin J Prac Nurs, 2013, 29(18):63-65.
[29] 赵洁. 40例白血病患者PICC非计划拔管原因分析与对策[J]. 中华护理杂志, 2007, 42(2):174-175.
[30] 国家卫生和计划生育委员会. 静脉治疗护理技术操作规范[J]. 中国护理管理, 2014, 14(1):1-3.
[31] 李海洋,黄金, 高竹林. 完全植入式静脉输液港应用及护理进展[J].中华护理杂志, 2012, 47(10):953-955.
[32] Saber W, Moua T, Williams EC, et al. Risk factors for catheter-related thrombosis (CRT) in cancer patients:a patient-level data (IPD) meta-analysis of clinical trials and prospective studies[J]. J Thromb Haemost, 2011, 9(2):312-319.
[33] Evans RS, Sharp JH, Linford LH, et al. Risk of symptomatic DVT associated with peripherally inserted central catheters[J]. Chest, 2010, 138(4):803-810.
[34] Bouza E, Burillo A, Muoz P. Catheter-related infections:diagnosis and intravascular treatment[J]. Clin Microbiol Infect, 2002, 8(5):265-274.
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