基于meta分析的肿瘤患者经外周置入中心静脉导管相关性静脉血栓形成风险预测模型构建

摘要

目的:采用Meta分析构建肿瘤患者经外周置入中心静脉导管(peripherally inserted central catheter,PICC)导管相关性静脉血栓形成风险预测模型.方法:系统检索探讨肿瘤患者PICC导管相关性静脉血栓形成危险因素的前瞻性和回顾性研究,经质量评价及数据提取后,采用meta 分析合并结果以获得各个危险因素的综合危险度(pooled odds ratio,ORP),并以综合危险度的自然对数转换值为基础构建风险预测模型.结果:经文献检索及筛查后,最终纳入符合标准的文献6篇,包括1 277例患者,其中病例组和对照组分别包括253和1 024例.Meta分析显示:基于累积样本的血栓发生率为19.81％.通过数据筛选,有5个危险因素进入模型,包括:COPD、高血压、糖尿病、化疗史、活动量减少,其综合危险度分别为:1.824,1.624,1.986,3.074和1.563.结论:以Meta分析结果为基础建立了具有循证基础的肿瘤患者PICC导管相关性静脉血栓形成风险预测模型.%Objective:Using meta-analysis technique to establish the risk predictive model of venous thromboembolism associated with peripherally inserted central catheters among cancer patients.Methods:The per-and prospective studies exploring risk factors contributing to development of venous thromboembolism associated with peripherally inserted central catheters among cancer patients were systematically identified.Meta-analysis technique was used to calculate the pooled odds ratio (ORP) after appraising the quality of eligible studies.And the risk predictive model will be established based on the values of translated the using natural logarithm approach.Results:Six studies were included.The sample size was 1 277 with 253 cases in the venous thromboembolism group and 1 024 cases in the control group.The incidence rate of venous thromboembolism associated with PICC was 19.81％.After screening,8 factors were included in the model,including COPD,hypertension,diabetes,history of chemotherapy and less activity,with pooled OR of 1.824,1.624,1.986,3.074 and 1.563,respectively.Conclusion:The present study establishes the risk predictive model of venous thromboembolism associated with peripherally inserted central catheters among cancer patients which was characterized by evidence-based basis using meta-analysis technique.