通过对国内已发表的有关肿瘤患者经外周中心静脉置管(PICC)与中心静脉置管(CVC)临床应用随机对照实验文献进行系统评价，进一步分析比较这两种置管方法在肿瘤患者临床应用中的效果及安全性。

计算机检索中国知网(CNKI)、万方和维普等数据库关于肿瘤患者PICC及CVC两种置管临床应用随机对照研究的文献，检索时间均从建库到2018年8月。由两位研究者根据纳入与排除标准独立筛选文献、提取数据资料和评价纳入研究的方法学质量后，采用MATLAB-R2016软件进行Meta分析。

共检索436篇文献，最终纳入文献19篇，共纳入2 242例肿瘤患者。Meta分析结果显示，PICC组一次置管成功率显著高于CVC组[RR＝1.16，95% CI(1.03～1.31)，P＝0.018]；PICC组置管留置时间显著大于CVC组[MD＝87.98，95% CI(54.64～121.33)，P<0.01]；PICC组导管脱落率显著低于CVC组[RR＝0.21，95% CI(0.12～0.37)，P<0.01]；PICC组导管感染率显著低于CVC组[RR＝0.23，95% CI(0.15～0.37)，P<0.01]；PICC组气胸发生率显著低于CVC组[RR＝0.16，95% CI(0.06～0.46)，P<0.01]；PICC组误入动脉的发生率显著低于CVC组[RR＝0.17，95% CI(0.08～0.36)，P＝0.001]；而PICC组静脉炎发生率显著高于CVC组[RR＝3.53，95% CI(2.15～5.81)，P<0.01]；此外两组导管阻塞发生率无统计学意义(P>0.05)。

PICC在肿瘤患者临床应用中具有一次置管成功率高、置管留置时间长、并发症少等特点，可更好、广泛地应用于临床肿瘤患者中。

To compare the efficacy and safety of peripherally inserted central catheter (PICC) and central venous catheter (CVC) in the clinical application of cancer patients by systematic evaluation of all published clinically relevant randomized controlled trials of those two catheterization methods.

The literature of randomized controlled clinical trials of PICC and CVC in cancer patients were retrieved from CNKI, WanFang Data and VIP databases. The retrieval time was from the establishment of the database to August 2018. Meta-analysis was performed using MATLAB-R2016 software after two researchers independently screened the literature, extracted data and evaluated the methodological quality of the included studies according to the inclusion and exclusion criteria.

A total of 436 articles were retrieved, and 19 articles were eventually included, involving 2 242 patients with cancer. Meta-analysis showed that the success rate of primary catheterization in the PICC group was significantly higher than that in the CVC group [RR=1.16, 95% CI (1.03-1.31), P=0.018]; the indwelling time in the PICC group was significantly longer than that in the CVC group [MD=87.98, 95% CI (54.64-121.33), P<0.01]; the catheter shedding rate in the PICC group was significantly lower than that in the CVC group [RR=0.21, 95% CI (0.12-0.37), P<0.01]. The catheter infection rate in the PICC group was significantly lower than that in the CVC group [RR=0.23, 95% CI (0.15-0.37), P<0.01]; the incidence of pneumothorax in the PICC group was significantly lower than that in the CVC group [RR=0.16, 95% CI (0.06-0.46), P<0.01]; the incidence of mistakenly entering arteries in the PICC group was significantly lower than that in the CVC group [RR=0.17, 95% CI (0.08-0.36), P=0.001]; and the incidence of phlebitis in the PICC group was significantly higher than that in the CVC group [RR=3.53, 95% CI (2.15-5.81), P<0.01]. In addition, there was no significant difference in the incidence of catheter obstruction between the two groups (P>0.05).

PICC has the characteristics of high success rate, long indwelling time and fewer complications in the clinical application of cancer patients, which can be widely used in clinical cancer patients. And the quality of all the research papers included in this study is low, the evaluation of the efficacy and safety of PICC and CVC needs to continue to increase the level of research forfurther validation analysis.