乳腺癌术后患侧上肢PICC置管化疗的临床应用

Breast Cancer Patients Postoperative Upper limb PICC Clinical Application Of Chemotherapy

目的探讨PICC在乳腺癌患者患侧上肢临床使用效果。方法确定健侧上肢无法置管,患侧上肢无肿胀,术中只结扎腋静脉的分支,对腋静脉没有影响的25例患者,实施患侧上肢PICC置管,置管后做好肢体及导管护理。结果 25例患侧置管患者,14例在贵要静脉置管,11例肘正中静脉置管,胸片显示:管尖端均进入上腔静脉中下端,留置时间为126～168d,6～8疗程。贵要静脉发生穿刺口感染1例,肘正中静脉发生静脉炎4例,经处理后症状改善,全部顺利完成化疗,无严重并发症发生,顺利拔管。结论正确评价患侧上肢血管,严格规范置管和导管维护,重视对患者宣教,乳腺癌患者患侧上肢可行PICC置管。

Objective To explore the role of PICC in breast cancer patients with upper side effect in clinical use. Methods Determine the healthy side upper limb cannot tube, upper limbs no swelling, intraoperative ligation of branches only axillary vein, 25 patients had no effect on the axillary vein, the implementation of the affected upper limb PICC catheter, catheter do after limb and catheter care. Results 25 cases of ipsilateral catheter, 14 cases in the basilic vein catheterization, 11 cases of median cubital vein catheter, chest radiograph shows： tube tip into the lower end of the superior vena cava, the indwelling time was 126 - 168 days, 6 - 8 courses. The basilic vein puncture infection occurred in 1 cases, 4 cases of phlebitis median cubital vein, the improvement of symptoms after treatment, all the successful completion of chemotherapy, no serious complications occurred, successful extubation. Conclusion The correct evaluation of ipsilateral upper extremity vascular, strictly regulate the catheter and catheter maintenance, pay attention to patient education, breast cancer patients with upper limb feasible PICC catheter.