恶性肿瘤患者中PICC插管与锁骨下静脉插管临床应用对比研究

Contrast study on the clinical application of peripheral Inserted Central Cathetersand under collarbone Central Venous Catheter for patients with malignant tumor

目的对比PICC管和锁骨下静脉插管在恶性肿瘤病人中临床应用情况及利弊。方法 36例经肘部外周静脉穿刺中心静脉置管的为PICC管组 ,4 0例经锁骨下静脉穿刺中心静脉置管的为锁穿组。分别记录插管成功率、操作所需时间、留管时间及不良反应发生情况。结果PICC管组一次插管成功率为 94 % ,锁穿组为 75 % ,P <0 0 1;PICC管组平均穿刺时间 13min ,锁穿组为 2 6min ,P <0 0 1;PICC管组平均留管时间为 70天 ,锁穿组为 35天 ,P<0 0 1;PICC管组不良反应发生率为 10 % ,锁穿组为 32 % ,P <0 0 1;二者成本效益分析基本持平。结论PICC管组较锁骨下静脉组一次置管成功率高 ,节省时间和人力 ,并发症低 ,保持静脉输液通道时间长 ,使得需长期输液的恶性肿瘤病人更方便、安全。

Objective To compare the clinical application, advantages and disadvantages of peripheral Inserted Central Catheters (PICC) and under collarbone Central Venous Catheter (CVC) for patients with malignant tumor. Method Thirty-six patients who were punctured peripherally inserted Central Catheters were selected as the group of PICC. Forty patients who were punctured under collarbone Central Venous Catheter were the group of CVC. The successful rate of tuber insertion operation time, retain time and side-reaction for the two group were recorded and evaluated. Results The success rate of insertion for group of PICC was 94℅, for group of CVC was 75℅. The mean time of puncture for PICC group was 13 min, for CVC group was 26 min. The PICC group can keep the catheters for 70 days, The CVC group is 35 days only. Moreover the incidence of side reaction for PICC group was 10℅. For CVC group was 32℅. There were significant differences between the two groups. The cost benefit for the two group was nearly the same. Conclusion Compared with group of CVC, The group of PICC is superior in successful rate, time and manpower saving, lower complication and retain time. And more secure and convenient for the patients with malignant tumor needed for long time transfusion .It is worth for extending in clinical application.