Wan Rong, Gu Lilei, Yin Bi, Cai Shengwei, Zhou Rengui, Yang Weilin
Department of Nursing, The 904th Hospital of Joint Logistic Support Force, Wuxi, China.
Department of Oncology, The 904th Hospital of Joint Logistic Support Force, Wuxi, China.
Perfusion. 2023 May;38(4):689-697. doi: 10.1177/02676591221076287. Epub 2022 Mar 2.
Peripherally inserted central catheters (PICCs), the most frequent central venous catheter, are used to provide medical treatments, although long-term PICC-related adverse outcomes are unknown in China. This study systematically investigated PICC-related complications in four Chinese hospitals.
Between January 2014 and January 2020, we analyzed the results of 3550 patients with PICC who were referred to four Chinese hospitals. All patients underwent PICC treatment in four Chinese hospitals. Patient-reported signs and symptoms of a putative PICC-related complication or functional were studied. Long-term outcomes and hospitalization costs were also evaluated.
An aggregate of 3285 patients were enrolled in the analytic cohort. 58.6% were females and 41.4% were males. The most common reasons for PICC placement included oncologic malignancy and critically ill patients. The majority of PICCs had valved systems (90.7%) and were implanted in the right side (85.5%) and into the basilic vein (87.7%). At least one potential PICC-related problem or adverse effects (AEs) was reported by 67.3% of patients. Central line-associated bloodstream infection (28.1%) and symptomatic deep vein thrombosis (20.7%) were the most common complications. The majority of PICCs were removed for causes other than AEs, with just 723 reported AEs accounting for 22.0% of all PICC removals. The most reasons for PICCs removal were occlusion (425, 12.9%) and exit-site infections (189, 5.8%).
This study is the first retrospective study in our country to explore PICC-related complications. While living with a PICC, more than 67.3% of patients report signs and symptoms of at least one PICC-related problem or adverse impacts, such as difficulties with PICC use and poor effects on physical and social function. In this group, PICCs are safe and effective, although the danger of PICC-related problems should not be disregarded.
经外周静脉穿刺中心静脉置管（PICC）是最常用的中心静脉导管，用于提供医疗治疗，尽管在中国长期PICC相关不良结局尚不清楚。本研究系统调查了四家中国医院中与PICC相关的并发症。
2014年1月至2020年1月期间，我们分析了转诊至四家中国医院的3550例PICC患者的结果。所有患者均在四家中国医院接受了PICC治疗。研究了患者报告的疑似PICC相关并发症或功能的体征和症状。还评估了长期结局和住院费用。
分析队列共纳入3285例患者。女性占58.6%，男性占41.4%。PICC置管最常见的原因包括肿瘤恶性疾病和危重症患者。大多数PICC具有瓣膜系统（90.7%），植入右侧（85.5%）和贵要静脉（87.7%）。67.3%的患者报告了至少一种潜在的PICC相关问题或不良反应（AE）。中心静脉导管相关血流感染（28.1%）和症状性深静脉血栓形成（20.7%）是最常见的并发症。大多数PICC因非AE原因拔除，仅723例报告的AE占所有PICC拔除的22.0%。PICC拔除的最常见原因是堵塞（425例，12.9%）和出口部位感染（189例，5.8%）。
本研究是我国第一项探索PICC相关并发症的回顾性研究。在携带PICC期间，超过67.3%的患者报告了至少一种PICC相关问题或不良影响的体征和症状，如PICC使用困难以及对身体和社会功能的不良影响。在这组患者中，PICC是安全有效的，尽管不应忽视PICC相关问题的风险。
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