Smith J R, Friedell M L, Cheatham M L, Martin S P, Cohen M J, Horowitz J D
Department of Surgery, Orlando Regional Medical Center, Florida 32806, USA.
Am J Surg. 1998 Aug;176(2):208-11. doi: 10.1016/s0002-9610(98)00121-4.
This study compares central venous catheters (CVC) and peripherally inserted central catheters (PICC) for indications for insertion, complications, and economic impact.
A retrospective review of 838 (283 CVC, 555 PICC) consecutively placed venous catheters reflected 49,365 CVC and 11,814 PICC days.
There were 57 (20%) complications in the CVC group, 197 (35%) complications in the PICC group. PICC were associated with a statistically significant increase in the incidence of catheter malfunction (P = 0.0005), arm vein phlebitis (P = 0.0004), and overall complications (P = 0.00001). A higher complication rate was noted in PICC inserted for chemotherapy (P = 0.00001) and parenteral hyperalimentation administration (P = 0.04). Charges for inpatient insertion of PICC and CVC were $500 and $2,500, respectively.
PICC have a significantly higher complication rate than CVC. PICC provide cost-effective central access of 2 to 3 weeks' duration, reserving operatively placed CVC for longer access requirements.
本研究比较了中心静脉导管（CVC）和经外周静脉穿刺中心静脉导管（PICC）在置管适应证、并发症及经济影响方面的差异。
回顾性分析838例连续置入的静脉导管（283例CVC，555例PICC），共涉及49365个CVC置管日和11814个PICC置管日。
CVC组发生57例（20%）并发症，PICC组发生197例（35%）并发症。PICC与导管功能障碍发生率（P = 0.0005）、臂静脉炎发生率（P = 0.0004）及总体并发症发生率（P = 0.00001）的统计学显著增加相关。化疗（P = 0.00001）和胃肠外营养输注（P = 0.04）时置入PICC的并发症发生率更高。住院期间置入PICC和CVC的费用分别为500美元和2500美元。
PICC的并发症发生率显著高于CVC。PICC可提供2至3周的经济有效的中心静脉通路，将手术置入的CVC用于更长时间的通路需求。
