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Objective To systematically evaluate the application efficacies of the peripherally inserted central catheter (PICC) and venous port access (VPA) during chemotherapy in the patients with malignant tumor.Methods The research data published in CNKI,WanFang Database and Pubmed Database were collected from October 2008 to December 2016.The related researches were screened according to the inclusion criteria.Then the meta analysis was performed by using the Revman Manager 5.3 software.Results Finally 63 articles were included for conducting the meta analysis,involving 11 296 patients.The one-time catheter placing success rate of VPA and PICC was investigated by 30 included articles,and the merged effect showed that the difference had no statistical significance (OR =0.96,95 ％ CI:0.75-1.23,P＞0.05).The analysis results of 16 articles showed that the proportion of the catheter indwelling time ≥ 1 year in the patients adopting VAP was higher than that in the patients adopting PICC (OR =27.17,95 ％ CI:18.08-40.83,P＜0.05).The incidence rate of complications in the patients adopting VPA was lower than that in the patients adopting PICC (OR =0.19,95 ％ CI:0.16-0.22,P＜0.01).The living quality of VPA and PICC was investigated by 11 included articles,which showed that the living quality in the VAP group was significantly higher than that in the PICC group (OR=8.53,95％CI:5.88-12.38,P＜0.05).Conclnsion The indwelling time of VPA during chemotherapy in the patients with malignant tumor is longer,the incidence rate of complications is lower and the patient's living quality is higher.
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Objective To analyze the difference of the venous port access (VPA) and peripherally inserted central catheter (PICC) in cancer chemotherapy.Methods All eligible studies on VPA and PICC were searched in the databases of PubMed,China National Knowledge Internet (CNKI),Chinese Biomedical Database (CBM),WANFANG Database and VIP Database.Literatures screening,quality evaluation and data extraction were conducted according to Cochrane Handbook;Meta-analysis was calculated by using RevMan 5.2.Results Twenty-nine studies with a total of 4 449 cases of patients were included in this Meta-analysis,with 1 912 cases in experimental group which adopted VPA and 2 537 cases in controlled group which adopted PICC.Experimental group had advantages in the average catheter retention time (SMD=3.36,95％CI 2.51-4.21) and quality of life (RR=1.61,95％CI 1.15-2.24) compared with controlled group.The overall complication rate (RR=0.26,95％CI 0.20-0.34,P＜0.01),phlebitis incidence (RR=0.08,95％CI 0.04-0.16,P＜0.01),catheter infection incidence (RR=0.32,95％CI 0.23-0.44,P＜0.01),catheter obstruction incidence (RR=0.32,95％CI 0.22-0.48,P＜0.01),catheter dystopy incidence (RR=0.18,95％CI 0.09-0.37,P＜0.01) in experimental group were remarkably lower than that in controlled group.However,no significant difference was found between the two groups in the incidence of the puncture success rate for the first time,errhysis or hematoncus,thrombus and catheter leakage (P ＞0.05).Conclusions Compared with PICC,VPA had advantages in a long retention time,fewer complications and few influence on quality of life.Therefore,VPA should be widely used in cancer chemotherapy.
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Objective To compare the effects of venous port access ( VPA ) with peripherally inserted central catheters ( PICC) in patients with breast cancer .Methods 120 cases with breast cancer were divided into 2 groups from Jan.2009 to Dec.2010,among whom 60 cases were with VPA when receiving operation , and the other 60 cases were with PICC after the operation .The success rate of catheterization , duration of catheter in-dwelling and catheter-related complications of the 2 groups were compared .Results The one-time success rate of catheterization was 100%in VPA group and 66.7%in PICC group .The catheters were retained for more than 12 months in 59 cases in VPA group,while only 4 cases in PICC group retained catheter for more than 12 months. The complications occurred to 1 case in VPA group ( 1.7%) and 9 cases in PICC group ( 15%) .Conclusion VPA is an ideal pathway for chemotherapy of patients with breast cancer , which can reduce nursing work and is worth to be promoted in clinical practice .