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皮下隧道技术改善接受外周静脉穿刺中心静脉置管化疗患者的治疗效果:一项随机对照试验

Subcutaneous tunneling technique to improve outcomes for patients undergoing chemotherapy with peripherally inserted central catheters: a randomized controlled trial.

作者信息

Xiao Mao-Fang, Xiao Cai-Qiong, Li Jia, Dai Can, Fan Yu-Ying, Cao Hui-Jiao, Qin Hui-Ying

机构信息

School of Nursing, Sun Yat-sen University, Yuexiu District, Guangzhou, Guangdong, China.

Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China.

出版信息

J Int Med Res. 2021 Apr;49(4):3000605211004517. doi: 10.1177/03000605211004517.

Abstract

OBJECTIVE

To compare the value of the subcutaneous tunneling technique versus the normal technique in improving the outcomes of patients undergoing chemotherapy with peripherally inserted central catheters (PICCs).

METHODS

One hundred thirty patients were randomly divided into an experimental group (subcutaneous tunneling technique) and control group (normal technique) according to the PICC placement technique, and clinical data were compared between the groups.

RESULTS

In total, 129 PICCs were successfully inserted. Compared with the control group, the experimental group had a lower occurrence of complications after placement (especially catheter dislodgement: 3.1% vs. 15.4%, venous thrombosis: 3.1% vs. 15.4%, and wound oozing: 14.1% vs. 27.7%), lower occurrence of unscheduled PICC removal (3.1% vs. 13.8%), greater comfort during placement (14.16 ± 2.21 vs. 15.09 ± 2.49 on a scale ranging from 6 to 30 points, with higher scores indicating lower degrees of comfort), and lower costs of PICC maintenance (median (interquartile range) per-day maintenance cost: 13.90 (10.99-32.83) vs. 15.69 (10.51-57.46) Yuan). The occurrence of complications and amount of bleeding during placement were not significantly different between the two groups.

CONCLUSIONS

The subcutaneous tunneling technique can improve PICC placement by reducing complications and costs of maintenance with better patient comfort during placement.

摘要

目的

比较皮下隧道技术与常规技术在改善经外周静脉穿刺中心静脉置管(PICC)化疗患者结局方面的价值。

方法

130例患者根据PICC置管技术随机分为实验组(皮下隧道技术)和对照组(常规技术),比较两组的临床资料。

结果

共成功置入129根PICC。与对照组相比,实验组置管后并发症发生率较低(尤其是导管移位:3.1% 对15.4%,静脉血栓形成:3.1% 对15.4%,伤口渗血:14.1% 对27.7%),计划外PICC拔除发生率较低(3.1% 对13.8%),置管时舒适度更高(6至30分评分中,14.16 ± 2.21对15.09 ± 2.49,分数越高舒适度越低),PICC维护成本较低(每日维护成本中位数(四分位间距):13.90(10.99 - 32.83)元对15.69(10.51 - 57.46)元)。两组置管时并发症发生率和出血量无显著差异。

结论

皮下隧道技术可通过减少并发症和维护成本,提高置管时患者舒适度来改善PICC置管效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d0b/8044577/d1d3dd19484c/10.1177_03000605211004517-fig1.jpg

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