植入式静脉输液港与PICC在乳腺癌患者化疗中的应用比较

Comparison of the Application of Implantable Intravenous Port and PICC in Chemotherapy of Breast Cancer Patients

目的比较植入式静脉输液港(IVAP)与经外周静脉穿刺中心静脉置管(PICC)在乳腺癌患者化疗中的应用效果。方法回顾性的方便选取2016年11月—2017年11月于该院进行化疗的乳腺癌术后患者共317例,按置管方式分为IVAP组(172例)和PICC组(145例),对比两组植入过程、并发症和处理方法。结果两组患者置管成功率方面对比差异无统计学意义(χ~2=0.644 9、0.644 9,P>0.05);IVAP组1年内导管进行重置率3.49%和意外拔管率0.00%的比例明显低于PICC组的重置率10.34%和意外拔管率6.90%,差异有统计学意义(χ~2=5.979 2、=12.248 5,P<0.05);IVAP组平均留置时间(245.32±88.65)d明显较PICC组(102.31±45.63)d长,差异有统计学意义(t=17.697 9,P<0.05);IVAP组的患者生活质量评分(82.31±10.02)分明显高于PICC组(66.25±11.00)分,差异有统计意义(t=13.593 4,P<0.05);IVAP组术后在导管堵塞、导管渗漏、感染的发生率上明显低于PICC组,差异有统计学意义(χ~2=7.445 7、10.599 1、8.149 7,P<0.05),尖端移位对比差异无统计学意义(χ~2=2.402 4,P>0.05)。结论:植入式输液港置管导管留置时间长,减轻护理工作量,并发症低,不限制乳腺患者的置管侧手臂活动,不影响患者的外观,使患者的生活质量得到极大的提高,临床上对于经济条件较好,需要长时间大剂量化疗或双侧乳腺癌患者可推广使用。而相对经济条件较差、化疗时间较短的患者建议使用PICC。

Objective To compare the effects of implanted IV port and peripheral venous catheterization(PICC)in chemotherapy for breast cancer patients.Methods A retrospective study of 317 patients with breast cancer who underwent chemotherapy from November 2016 to November 2017 was convenient divided into IVAP group(172 cases)and PICC group(145 cases).Two groups of implantation procedures,complications and treatment methods were compared.Results There was no significant difference in the success rate of catheterization between the two groups(χ2=0.644 9,0.644 9,P>0.05).The ratio of catheter replacement rate of 3.49%and accidental extubation rate of 0.00%was significantly lower in the IVAP group within 1 year.The PICC group had a replacement rate of 10.34%and an accidental extubation rate of 6.90%,which was statistically significant(χ2=5.979 2,12.248 5,P<0.05).The average indwelling time of the IVAP group was(245.32±88.65)d,which was significantly longer than the PICC group of(102.31±45.63)d.Statistically significant(t=17.697 9,P<0.05);the quality of life score of the IVAP group was(82.31±10.02)points significantly higher than that of the PICC group(66.25±11.00)points,statistically significant(t=13.593 4,P<0.05);The incidence of catheter occlusion,catheter leakage,and infection was significantly lower than that of the PICC group,which was statistically significant(χ2=7.445 7,χ2=10.599 1,χ2=8.149 7,P<0.05).There was no statistically significant difference in tip displacement(χ2=2.402 4,P>0.05).Conclusion The indwelling port of the implanted infusion port has a long indwelling time,reduces the workload of nursing,has low complications,does not limit the activity of the lateral arm of the breast patient,does not affect the appearance of the patient,and greatly improves the quality of life of the patient.Clinically,patients with good economic conditions need long-term high-dose chemotherapy or bilateral breast cancer can be promoted.PICC is recommended for patients with relatively poor economic conditions and short chemotherapy times.