PICC在鼻咽癌同期放化疗中的应用效果观察

Application effect observation of PICC in the concurrent chemoradiation of nasopharyngeal carcinoma

目的探讨经外周静脉置入中心静脉导管(PICC)在鼻咽癌(NPC)患者同期放化疗中的应用效果。方法选择2015年9月~2017年8月入院行同期放化疗的NPC患者93例,根据患者意愿分成观察组63例和对照组30例。观察组采用PICC,对照组采用经外周静脉留置针。同期放化疗开始前及开始后3个月,采用EORTC QLQ-C30量表问卷调查的方式对两组进行生活质量评估,记录治疗前后体重情况,治疗期间静脉输液并发症发生情况。结果治疗前,两组生活质量各领域评分比较,差异无统计学意义(P>0.05)。在功能领域及总体健康状况这两个正向生活质量指标方面,两组治疗后的评分均低于治疗前,治疗3个月后观察组评分均高于对照组,差异有统计学意义(P<0.05)。在症状领域这个负向生活质量指标方面,治疗后在疲劳、恶心呕吐、失眠方面观察组评分均低于对照组,差异有统计学意义(P<0.05),而在疼痛、呼吸困难、便秘、腹泻、食欲缺乏与经济压力方面观察组与对照组比较,差异无统计学意义(P>0.05)。治疗后两组的体重均较治疗前减轻,差异均有统计学意义(P<0.05)。但治疗后观察组体重变化的百分比高于对照组,差异有统计学意义(P<0.05)。治疗后两组的体重均较治疗前减轻,但观察组体重减轻情况较对照组好。在并发症发生率方面,观察组静脉炎、化学药物渗漏、重复静脉穿刺的发生率均低于对照组,差异有统计学意义(P<0.05)。结论在NPC同期放化疗中使用PICC,与传统静脉留置针比较,更有助于患者生活质量及营养的改善,输液并发症更少。

Objective To investigate the application effect of peripherally inserted central catheter（PICC） in the concurrent chemoradiation of nasopharyngeal carcinoma patients. Methods Ninety-three nasopharyngeal carcinoma patients who underwent radiotherapy and chemotherapy in the same period from September 2015 to August 2017 were selected and divided into observation group（n=63） and control group（n=30） according to the patient′s will. The PICC was used in the observation group, and the peripheral venous indwelling needle was used in the control group. Before and 3 months after radiotherapy and chemotherapy in the same period, the quality of life of the two groups was evaluated by the EORTC QLQ-C30 questionnaire. The weight of the patients before and after treatment was recorded, and the incidence of complications of intravenous infusion during the treatment were recorded. Results Before treatment, there was no significant difference in the scores of the quality of life between the two groups（P〈0.05）. In terms of the functional areas and the overall health status of the two positive indicators of quality of life, the scores after treatment in both groups were lower than before treatment. Three months after treatment, the scores of the observation group were higher than those of the control group with statistical significance（P〈0.05）. In terms of the negative quality of life index in the symptom scope, the scores of fatigue, nausea, vomiting and insomnia in the observation group were lower than those in the control group after treatment（P〈0.05）, but in terms of pain, dyspnea, constipation, diarrhea, loss of appetite and economic burden, there was no significant difference between the two groups（P〈0.05）. After treatment,the body weight of the two groups were decreased compared with those before treatment with significant differences（P〈0.05）. However, the percentage of body weight change in the observation group after treatment was higher than that in the control group with a statistical difference（P〈0.05）. After treatment, the body weight of both groups were lower than before treatment, but the weight loss in the observation group was more better than that in the control group. With regards to the incidence of complications, the incidence of phlebitis, leakage of chemical drugs, and repeated venipuncture in the observation group was lower than that in the control group with a significant difference（P〈0.05）. Conclusion The use of PICC in concurrent radiochemotherapy for nasopharyngeal carcinoma is more beneficial to the improvement of the quality of life and nutrition compared with the traditional intravenous indwelling needle and has fewer complications during infusion.