IV Catheter Care Clinic, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan, PR China.
Nursing Department, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan, PR China.
J Vasc Access. 2024 Nov;25(6):1894-1903. doi: 10.1177/11297298231192171. Epub 2023 Aug 17.
At the site of peripherally inserted central catheter (PICC) catheterization in tumor patients, medical adhesive-related skin injury (MARSI) was reported related to patient age, infusion of certain chemotherapeutic agents, and tumor type, but did not review its relation to the use of clear patches and the puncture site of PICC. This study aims to analyze the risk factors for MARSI in more detail to provide supported data for reducing MARSI.
Total 382 cancer patients receiving catheterization via PICC were involved in this study from March 1, 2021, to September 28, 2021. According to MARSI occurrence or not, they were assigned into MARSI or non-MARSI group. Univariate and multivariate logistic regressions were used to analyze the risks of MARSI occurrence at PICC insertion site.
15% (60 of 382 cases) resulted in MARSI, out of which 8.1% (31/382) was categorized as contact dermatitis, and 7.1% (27/382) as mechanical injuries. The univariate analysis showed that there were significant differences in six aspects of the study, including BMI, MARSI history, dressing types, treatment by paclitaxel or 5-FU versus oxaliplatin, dressing frequency, and catheterization at biceps brachii medial ( < 0.05). Via multivariate logistic regression analysis, it was discovered that except for previously reported risk factors, dressing change frequency (OR (95% CI) = 7.49 (2.36-23.80), = 0.001), catheterization at biceps brachii medial (OR (95% CI) = 4.07 (1.82-9.10), = 0.001), and breast cancer (OR (95% CI) = 3.27 (1.05-10.15), = 0.041), there were significant risk factors for MARSI occurrence in tumor patients with PICC catheterization.
Our study revealed a high incidence of MARSI at the PICC insertion site of cancer patients, presenting with contact dermatitis and mechanical injury. Independent risk factors were previous history of MARSI, a diagnosis of breast cancer, frequent dressing replacement, use of paclitaxel or 5-FU, and PICC catheterization at biceps brachii medial.
在外周置入中心静脉导管（PICC）置管部位，据报道，与患者年龄、输注某些化疗药物和肿瘤类型有关的医用胶粘剂相关皮肤损伤（MARSI），但并未回顾其与透明敷贴的使用和 PICC 穿刺部位的关系。本研究旨在更详细地分析 MARSI 的危险因素，为降低 MARSI 提供支持数据。
2021 年 3 月 1 日至 2021 年 9 月 28 日，本研究共纳入 382 例接受 PICC 置管的癌症患者。根据 MARSI 是否发生，将其分为 MARSI 组和非 MARSI 组。采用单因素和多因素逻辑回归分析 PICC 置管部位发生 MARSI 的危险因素。
15%（60/382 例）发生 MARSI，其中接触性皮炎 8.1%（31/382），机械性损伤 7.1%（27/382）。单因素分析显示，在 BMI、MARSI 史、敷贴类型、紫杉醇或 5-FU 与奥沙利铂治疗、敷贴更换频率、肱二头肌内侧置管等 6 个方面差异有统计学意义（ < 0.05）。多因素逻辑回归分析发现，除了已报道的危险因素外，敷贴更换频率（OR（95%CI）=7.49（2.36-23.80）， = 0.001）、肱二头肌内侧置管（OR（95%CI）=4.07（1.82-9.10）， = 0.001）和乳腺癌（OR（95%CI）=3.27（1.05-10.15）， = 0.041）是肿瘤患者 PICC 置管部位发生 MARSI 的显著危险因素。
本研究揭示了癌症患者 PICC 置管部位 MARSI 发生率较高，表现为接触性皮炎和机械性损伤。独立危险因素包括既往 MARSI 史、乳腺癌诊断、频繁更换敷贴、紫杉醇或 5-FU 治疗、肱二头肌内侧 PICC 置管。
