Dai Can, Li Jia, Li Qiu-Mei, Guo Xiuquan, Fan Yu-Ying, Qin Hui-Ying
School of Nursing, Sun Yat-sen University, Guangzhou, China.
Department of Catheter Clinic, Sun Yat-sen University Cancer Center, Guangzhou, China.
J Vasc Access. 2020 Jul;21(4):511-519. doi: 10.1177/1129729819888120. Epub 2019 Nov 11.
To compare the effect of tunneled and nontunneled peripherally inserted central catheter placement under B-mode ultrasound.
A single center, randomized, controlled, nonblinded, prospective trial was conducted in Guangzhou, China, between July 2018 and May 2019. A total of 174 participants were randomized to the experimental group (tunneled peripherally inserted central catheter) or the control group (nontunneled peripherally inserted central catheter) and were followed until extubation. Basic characteristics, peripherally inserted central catheter characteristics, the incidence of complications, and the costs of peripherally inserted central catheter placement and maintenance were collected. Data were analyzed by intention-to-treat.
A total of 168 of the participants had successful peripherally inserted central catheter placements (85/87, 97.7% in the experimental group and 83/87, 95.4% in the control group, = 0.682). Compared to the control group, the experimental group had a lower incidence of complications during the placement (18.4% vs 32.2%, = 0.036), a lower incidence of wound oozing (27.6% vs 57.5%, < 0.001), a lower incidence of medical adhesive-related skin injury (9.2% vs 25.3%, = 0.005), a lower incidence of venous thrombosis (1.1% vs 9.2%, = 0.034), a lower incidence of catheter dislodgement (1.1% vs 9.2%, = 0.034), and lower costs of peripherally inserted central catheter maintenance at 1, 2, and 3 months ( < 0.05).
Tunneled peripherally inserted central catheter may be recommended for good effectiveness.
比较在B超引导下经隧道式与非隧道式外周静脉穿刺中心静脉置管的效果。
2018年7月至2019年5月在中国广州开展了一项单中心、随机、对照、非盲法前瞻性试验。共174名参与者被随机分为试验组（经隧道式外周静脉穿刺中心静脉置管）或对照组（非隧道式外周静脉穿刺中心静脉置管），并随访至拔管。收集基本特征、外周静脉穿刺中心静脉导管特征、并发症发生率以及外周静脉穿刺中心静脉置管和维护的费用。采用意向性分析方法进行数据分析。
共有168名参与者外周静脉穿刺中心静脉置管成功（试验组85/87，成功率97.7%；对照组83/87，成功率95.4%，P = 0.682）。与对照组相比，试验组置管期间并发症发生率较低（18.4% 对32.2%，P = 0.036），伤口渗血发生率较低（27.6% 对57.5%，P < 0.001），医用黏胶相关皮肤损伤发生率较低（9.2% 对25.3%，P = 0.005），静脉血栓形成发生率较低（1.1% 对9.2%，P = 0.034），导管移位发生率较低（1.1% 对9.2%，P = 0.034），且在1、2和3个月时外周静脉穿刺中心静脉导管维护费用较低（P < 0.05）。
经隧道式外周静脉穿刺中心静脉置管效果较好，可予以推荐。
