以质量求发展，以服务铸品牌

Journal of Nursing ›› 2019, Vol. 26 ›› Issue (11): 49-54.doi: 10.16460/j.issn1008-9969.2019.11.049

Previous Articles     Next Articles

Risk Factors of PICC-related Venous Thrombosis in Cancer Patients: A Meta-analysis

TIAN Ting1, HUANG Rui-na1, QI Yi1, ZHOU Ya-juan1, HAN Hui1, LIU Wan-jun1, HE Hai-xia2, WU Xiao-wan1   

  1. 1. School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou 510006;
    2. Dept. of Gynecology, Guangdong Proncivial Hospital of Traditional Chinese Medicine, Guangzhou 510120, China
  • Received:2018-12-10 Published:2020-07-08

PDF (PC)

342

Like

Abstract: Objective To identify the risk factors of PICC-related venous thrombosis in cancer patients through meta analysis and provide reference for the prevention and reduce of PICC-related venous thrombosis. Methods We retrieved CNKI, CBM, Wangfang Datbase, VIP, Baidu Library, PubMed, Embase, Web of Science, Medline, Cochrane from the inception to November 2018 to collect case-control studies and cohort studies on risk factors of PICC-related venous thrombosis in cancer patients. Meta analysis was performed by using Stata 13.0 and the Egger's linear regression to test publication bias. Results There were 18 included articles of 6, 425 patients, 825 in case group/exposed group and 5, 600 in control group/non-case group. Risk factors and OR value were as follows: aged over 60, 2.560 (95%CI：1.653~3.967); overweight or obesity, 3.552 (95%CI：2.103~5.998), combined with hypertension, 2.041 (95%CI：1.302~3.200), combined with diabetes, 2.021 (95%CI：1.695~2.409 ), a history of PICC, 2.188 (95%CI：1.204~3.976), having radiotherapy with PICC, 4.308 (95%CI：1.901~9.763), inadequate activity, 4.559 (95%CI：1.035~20.085), infection, 2.748 (95%CI：1.397~5.408), TNM stage III to IV 2.746 (95%CI：1.643~4.589) and tumor metastasis, 4.023 (95%CI：1.895~8.544). Egger's linear regression showed that publication bias was found pertaining to inadequate activity, tumor metastasis and having radiotherapy with PICC. Conclusion Risk factors of PICC-related venous thrombosis in cancer patients include aged over 60, overweight or obesity, combined with hypertension or diabetes, a history of PICC, infection and TNM stage III to IV but there are not adequate evidences for risk factors such as inadequate activity, tumor metastasis and having radiotherapy with PICC. Early intervention should be performed for changeable risk factors and more monitoring for unchangeable ones.

Key words: cancer, PICC, venous thrombosis, risk factor, Meta analysis

CLC Number: 

  • R472.9
[1] 肖芳,王娜,潘艳华.肿瘤患者PICC置管术后相关上肢静脉血栓的研究进展[J].中华肿瘤防治杂志,2018,25(S1):308-312.DOI:10.16073/j.cnki.cjcpt.20181102.010.
[2] 朱丽群,庄若,曹松梅,等. PICC相关性血栓风险评估的最佳证据总结[J].中华护理杂志, 2017, 52(10):1179-1185.DOI:10.3761/j.issn.0254-1769.2017.10.005.
[3] 王丽丽,王金荣,高攀,等.中心静脉置入设备相关上肢深静脉血栓形成的诊断、预防和治疗[J].中国呼吸与危重监护杂志, 2018,17(5):532-538.DOI:10.7507/1671-6205.201710007.
[4] Jones D, Wismayer K, Bozas G, et al.The Risk of Venous Thromboembolism Associated with Peripherally Inserted Central Catheters in Ambulant Cancer Patients[J]. Thromb J,2017(15):25.DOI:10.1186/s12959-017-0148-y.
[5] 于瑞,陈利芬.肿瘤患者PICC导管相关静脉血栓形成影响因素Meta分析[J]. 中国护理管理,2016,16(6):738-743.DOI:10.3969/j.issn.1672-1756.2016.06.005.
[6] 秦霞,田利,李惠玲,等.内科住院病人发生静脉血栓栓塞症危险因素的Meta分析[J].现代预防医学,2018,45(4):753-756.
[7] Wells G, Shea B, O'Connell D, et al. The Newcastle-ottawa Scale (NOS) for Assessing the Quality of Non-randomised Studies in Meta-analyses[EB/OL].(2018-02-26)[2018-03-18].http://www.ohri.ca/programs/clinical_epidemiology/oxford.htm.
[8] 刘聿秀. 肿瘤患者PICC相关上肢静脉血栓及其危险因素的研究[D].青岛:青岛大学,2010.
[9] 李琦. 肿瘤患者PICC相关上肢静脉血栓形成的临床分析[D]. 杭州:浙江大学, 2015.
[10] 于瑞,陈利芬,周雪梅,等.肿瘤患者PICC导管相关血栓形成危险因素的研究[J].中国护理管理,2016,16(10):1326-1330.DOI:DOI10.3969/j.issn.1672-1756.2016.10.008.
[11] 邢淑云. 肿瘤患者PICC相关性血栓发生状况的临床观察及相关因素分析[D]. 青岛:青岛大学,2017.
[12] 原娜,王磊,武雪亮.肺癌化疗患者经外周中心静脉置管术相关性静脉血栓的危险因素分析[J].中国医药导报, 2017,14(26):86-89,97.
[13] 张丽,陆箴琦,陆海燕,等.肿瘤患者PICC导管相关性血栓形成的相关因素分析[J].护理学杂志,2017,32(14):51-55.DOI:10.3870/j.issn.1001-4152.2017.14.051.
[14] 关晨阳,廖海涛,高文,等.肿瘤病人PICC导管相关性血栓的危险因素分析[J].护理研究,2017,31(10):1211-1215.DOI:10.3969/j.issn.1009-6493.2017.10.017.
[15] 宋轶凡. 肿瘤患者PICC置管术后上肢静脉血栓形成的相关因素研究[J]. 基层医学论坛,2018,22(26):3748-3750.DOI:10.19435/j.1672-1721.2018.26.080.
[16] 张伟伟,方云.血液肿瘤患者PICC导管相关性血栓形成的危险因素分析[J].临床血液学杂志,2018,31(2):197-200.DOI:10.13201/j.issn.1004-2806.2018.03.008.
[17] Shi Y, Wen L, Zhou Y, et al.Thrombotic Risk Factors in Patients Undergoing Chemotherapy Via Peripherally Inserted Central Catheter[J]. J Int Med Res,2014,42(3):863-9.DOI:10.1177/0300060514527061.
[18] Liu Y, Gao Y, Wei L,et al.Peripherally Inserted Central Catheter Thrombosis Incidence and Risk Factors in Cancer Patients: A Double-center Prospective Investigation[J]. Ther Clin Risk Manag,2015(11):153-160.DOI:10.2147/TCRM.S73379.
[19] Kang J, Sun W, Li H, et al.Peripherally Inserted Central Catheter-related Vein Thrombosis in Breast Cancer Patients[J].J Vasc Access ,2016, 17(1):67-71.DOI:10.5301/jva.5000457.
[20] Kang J R, Long L H, Yan S W, et al.Peripherally Inserted Central Catheter-related Vein Thrombosis in Patients with Lung Cancer[J]. Clin Appl Thromb Hemost, 2017,23(2):181-186.DOI:10.1177/1076029615595880.
[21] Aw A, Carrier M, Koczerginski J, et al.Incidence and Predictive Factors of Symptomatic Thrombosis Related to Peripherally Inserted Central Catheters In Chemotherapy Patients[J]. Thromb Res,2012,130(3):323-326.DOI:10.1016/j.thromres.2012.02.048.
[22] Ahn D H, Illum H B, Wang D H, et al.Upper Extremity Venous Thrombosis in Patients with Cancer with Peripherally Inserted Central Venous Catheters: A Retrospective Analysis of Risk Factors[J]. J Oncol Pract,2013,9(1):e8-12.DOI:10.1200/JOP.2012.000595.
[23] Yi X L, Chen J, Li J, et al.Risk Factors Associated with PICC-related Upper Extremity Venous Thrombosis in Cancer Patients[J]. J Clin Nurs,2014,23(5/6):837-843.DOI:10.1111/jocn.12227.
[24] Liang Y J, He Y, Li J M, et al.The Incidence and Predictors of Symptomatic Venous Thromboembolism Associated with Peripherally Inserted Central Catheters in Patients with Nasopharyngeal Carcinoma[J]. Onco Targets Ther,2018(11):3119-3127.DOI:10.2147/OTT.S164723.
[25] 李斌,颜秀英,刘寿,等.老年人消化性溃疡危险因素的Meta分析[J].现代预防医学,2017,44(8):1371-1376.
[26] Oger E, Leroyer C, Le Moigne E, et al.The Value of a Risk Factor Analysis in Clinically Suspected Deep Venous Thrombosis[J].Respiration,1997(64):326-330.
[27] 中国临床肿瘤学会肿瘤与血栓专家共识委员会.中国肿瘤相关静脉血栓栓塞症预防与治疗专家指南(2015版)[J].中国实用内科杂志,2015,35(11):907-920.DOI:10.7504/nk2015100201.
[28] 周晔,刘扣英,崔焱.握拳频次对PICC置管病人上肢静脉血液流速的影响[J].护理研究, 2016,30(5C):1838-1840.DOI:10.3969/j.issn.1009-6493.2016.15.015.
[29] 李雪娇,王健,皮红英.上肢加压对经外周置入中心静脉导管患者血流动力学影响的研究[J]. 解放军护理杂志,2018,35(18):46-49.DOI:10.3969/j.issn.1008-9993.2018.18.010.
[30] 金咏梅,邸英莲,徐春静,等.温和灸对胃肠道恶性肿瘤患者PICC相关性上肢静脉血栓预防的效果研究[J].中华护理杂志,2017, 52(7):854-857.DOI:10.3761/j.issn.0254-1769.2017.07.018.
[31] 袁会军,钱才,黄燕.高血压与下肢深静脉血栓形成的相关性研究[J].血栓与止血学,2017,23(5):804-806.
[32] 王建枝,殷莲华.病理生理学[M].8版.北京:人民卫生出版社,2013:70-71.
[33] 莫春玲,屈盈莹,罗淑娟.肿瘤患者同时发生PICC导管相关性血栓和血流感染的病例分析[J].岭南现代临床外科,2017, 17(2):221-223.DOI:10.3969/j.issn.1009-976X.2017.02.022.
[34] Khorana A A, Dalal M, Lin J.Incidence and Predictors of Venous Thromboembolism (VTE) Among Ambulatory High-risk Cancer Patients Undergoing Chemotherapy in the United States[J].Cancer,2013,119(3):648-655.DOI:10.1002/cncr.27772.
[35] 张学振,陈国荣.恶性肿瘤高凝状态患者的临床特征[J].现代肿瘤医学,2017,25(13):2100-2103.DOI:10.3969/j.issn.1672-4992.2017.13.023.
[36] Donati M B.Thrombosis and Cancer: 40 Years of Research[J].Thromb Res,2012, 129(3):348-352.DOI:10.1016/j.thromres.2011.12.022.
[37] Rajasekhar A.How I Treat Central Venous Access Device-related Upper Extremity Deep Vein Thrombosis[J]. Blood,2017, 129(20):2727-2736. DOI:10.1182/blood-2016-08-693671.
[38] Guy J B, Bertoletti L, Magné N, et al.Venous Thromboembolism in Radiation Therapy Cancer Patients: Findings from the RIETE Registry[J].Crit Rev Oncol Hematol,2017(113):83-89.DOI:10.1016/j.critrevonc.2017.03.006.
[39] 倪婷婷,何倩颖.肿瘤患者PICC相关性血栓发生的危险因素及预防研究进展[J].护理学报,2017,24(15):44-47. DOI:10.16460/j.issn1008-9969.2017.15.044.
[1] ZHU Yi-fan, CHEN Zhi-qian, GUO Qiao-hong, SU Ya-li. Current Status of Dignity of 196 Breast Cancer Women Receiving Chemotherapy and Its Influence Factors [J]. Journal of Nursing, 2020, 27(12): 33-37.
[2] CHEN Long-xia, HOU Yun-xia, YU Li-juan. Reproductive Concerns of Young Married Female Patients with Lung Cancer and Its Influence Factors: A 239-case Study [J]. Journal of Nursing, 2020, 27(11): 57-60.
[3] LI Xi-zhen, CAO Mei-chang, DENG Ju-ying, ZENG Man-ping, OU Li-fang. Effect of Narrative Therapy on Fear of Cancer Recurrence and Level of Hope in Patients with Nasopharyngeal Carcinoma [J]. Journal of Nursing, 2020, 27(11): 71-74.
[4] YUAN Li, XU Yi-yuan, DING Shu-zhen, FENG Hong. Current Status of Adjustment in Enterostomy Patients and Its Influence Factors [J]. Journal of Nursing, 2019, 26(15): 1-4.
[5] QIN Ru-meng, LU Cai-yun, ZHOU Li-hua, HUANG Xiu-hua, ZHONG Qi. Current Status of Post-traumatic Growth of Gynecological Cancer Patients and Its Influence Factors [J]. Journal of Nursing, 2019, 26(15): 9-13.
[6] ZHANG Yang, LUO Tai-zhen, LIN Yan-shan, AN Chun-yan, ZENG Xi-gen. Neuropsychological Study of Cancer-related Cognitive Impairment in Women with Gynecological Cancer [J]. Journal of Nursing, 2019, 26(15): 70-75.
[7] LI Jia-qia, ZHU Bing-jie, LI Meng-yuan, YAN Ling. Status Quo of Fear of Progression in Spouses of Advanced Cancer Patients and Its Correlation Factors [J]. Journal of Nursing, 2019, 26(14): 5-9.
[8] LI Wen-ji, LI Xiao-jin, ZHOU Chun-lan. Effectiveness of Complex Decongestive Therapy in Lymphedema of Postoperative Breast Cancer Patients: A Systematic Review [J]. Journal of Nursing, 2019, 26(12): 51-56.
[9] CHEN Meng-jin,LI Hai-xiang,HUANG Chun-xiang,YAO Xiong,WANG Xi-ying,YANG Jie-wei. Effect of Peer Education on Self-management and Complication of Cancer Patients with PICC [J]. Journal of Nursing, 2018, 25(8): 75-78.
[10] CAI Jian-ping,JIANG Zi-fang. Reliability and Validity of Chinese Version of Fear of Progression Questionnaire-Short Form in Women with Breast Cancer [J]. Journal of Nursing, 2018, 25(7): 5-8.
[11] YAN Xue-mei,HAN Yan,WANG Yi-lan,SU Jian-ping. Development of Patient Outcome-based Sensitive Indicator System of Thoracoscopic and Laparoscopic Radical Resection of Esophageal Cancer [J]. Journal of Nursing, 2018, 25(4): 37-42.
[12] PENG Qing,LI Xue,ZHANG Xue,SU Jian-ping. Status and Influence Factors of Posttraumatic Growth in Cervical Cancer Patients Receiving Chemotherapy [J]. Journal of Nursing, 2018, 25(3): 5-10.
[13] LI Zhen, CAO Jing, LI Jia-qian, WU Xin-juan. Systematic Review and Meta-analysis of Risk Factors of Post Stroke Delirium [J]. Journal of Nursing, 2018, 25(22): 38-43.
[14] WANG Chun-li, CUI Jie, ZHEN Ying-zi, DING Ya-guang, ZHANG Yu-ling, YE Jing. Complications in 161 Children PICC Maintenance Clinic and Its Nursing [J]. Journal of Nursing, 2018, 25(22): 62-64.
[15] ZHANG Hai-hong, SUN Yu-mei, CUI Liang, Zhang Li-jie, SU Ye, XING Peng-bo, GAO Jiang-ping. Case-control Study on Relationship between Urine Components and Urinary Calculus in Pilots [J]. Journal of Nursing, 2018, 25(21): 47-50.
Viewed
Full text


Abstract

Cited
  Shared   
[1] . [J]. Journal of Nursing, 2013, 20(11): 25 -27 .
[2] LI Yuan, ZHANG Rui, LU Yan-yan, Ning Pei, LI Xue, MENG Qing-hui. Study Methods of Nursing Postgraduates of Critical Illness from Perspectives of Tutors and Postgraduates[J]. Journal of Nursing, 2020, 27(11): 1 -5 .
[3] ZHAO Di, ZHAO Meng-Lu, WANG Na, FU Ming-Jing, LIANG Feng, ZHANG Wei, WANG Ai-Min. Current Status of Social Isolation of Community-dwelling Elderly People in Qingdao and Its Influencing Factors[J]. Journal of Nursing, 2020, 27(11): 6 -10 .
[4] . [J]. Journal of Nursing, 2020, 27(11): 11 -15 .
[5] XIE Yan-zhen, LI Zhuang-miao, ZHANG Jia-yu, JI Qiu-lu, WU Yu-xin. Bibliometric Analysis of Moxibustion for Hemiplegia after Stroke[J]. Journal of Nursing, 2020, 27(11): 16 -20 .
[6] . [J]. Journal of Nursing, 2020, 27(11): 21 -25 .
[7] ZHANG Ai-qin, CHEN Jun-shan, YU Jin-tian. Guidelines on Non-pharmacological Management of Delirium in ICU Patients：A Systematic Review[J]. Journal of Nursing, 2020, 27(11): 26 -32 .
[8] YE Dong-ting, ZHANG Qin-lian, JING Shuang, GUO Jia, XING Yan-fen. Psychological Experience of Family Members of ICU Patients during ICU Transfer: A Meta-synthesis[J]. Journal of Nursing, 2020, 27(11): 33 -39 .
[9] LIU Min, LIU An-nuo, WU De-quan, GAO Yu, CHEN Guo-hong, ZHU Gui-yue, ZHANG Meng, MA Wen, DING Cui-lu. Effect of Exercise on Walking Function of Elderly Type 2 Diabetic Patients：A Meta-analysis[J]. Journal of Nursing, 2020, 27(11): 40 -45 .
[10] GUO Xiao-yu, SHI Dong-li, ZHANG Zheng-mei, LI Na, ZHANG Pei-feng, YANG Li-juan. Best Evidence Summary for Early Removal of Urinary Catheters in Male Patients after Lumbar Spine Surgery under General Anethesia[J]. Journal of Nursing, 2020, 27(11): 46 -51 .