腔内心电图技术在肿瘤化疗患者上臂植入式输液港中的运用

Application of intracavitary electrocardiographic technique in the implantable infusion port in the upper arm of oncology chemotherapy patients

目的 探讨腔内心电图技术在肿瘤化疗患者上臂植入式输液港中的应用价值,为后续开展相关临床操作提供参考。方法 选取2021年1月—2022年11月在长沙市某三级甲等医院肿瘤科化疗的患者240例为研究对象,按照组间基线资料均衡可比的原则分为对照组和观察组,每组120例。对照组在超声引导下置入中心静脉导管,根据体外测量法估算导管长度后行X线检测确认导管尖端位置,由医生在上臂皮下埋入输液港。观察组在超声引导下置入中心静脉导管后,应用腔内心电图根据P波的变化确认定位导管尖端位置,由医生在上臂皮下埋入输液港。观察两组患者置港成功时间、维护时间以及置管费用、置港舒适度和置管并发症。结果 观察组患者置港成功时间、维护时间短于对照组,差异有统计学意义(P<0.05);观察组患者置管费用少于对照组,差异有统计学意义(P<0.05);观察组患者在置港过程中对简单活动的影响程度及疼痛程度评分低于对照组,差异有统计学意义(P<0.05);观察组患者置管并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论 相比较X线摄片的优势,腔内心电图技术可有效辅助植入上臂输液港,减少置港成功时间、维护时间及置港费用,提升患者的舒适度,降低并发症发生率,此方法简单易行、治疗成本低、安全性高。

Objective To explore the application value of intracavitary electrocardiography technology in the implantable infusion port of the upper arm of tumor chemotherapy patients,to provide reference for the subsequent development of related clinical operations.Methods 240 patients undergoing chemotherapy in the Department of Oncology of a Class III Grade A hospital in Changsha from January 2021 to November 2022 were selected as the study subjects,they were divided into a control group and an observation group of 120 cases each in accordance with the principle of balanced and comparable baseline data between the groups.In the control group,a central venous catheter was inserted under ultrasound guidance,to estimated the length of the catheter according to the in vitro measurement method,and then X-Ray examination was performed to confirm the position of the tip of the catheter,and the doctor buried the infusion port under the skin of the upper arm.In the observation group,after the central venous catheter was inserted under ultrasound guidance,endoluminal electrocardiography was applied to confirm the location of the catheter tip according to the change of P wave,the infusion port was embedded subcutaneously in the upper arm by the doctor.The successful time of port placement and maintenance time as well as the cost of catheterization,comfort of port placement and complications of catheterization were observed in the two groups.Results The successful port placement time and maintenance time of patients in the observation group were shorter than those in the control group,and the difference was statistically significant(P<0.05);the cost of tube placement of patients in the observation group was less than the control group,and the difference was statistically significant(P<0.05);the degree of influence on the simple activities and the score of the degree of pain in the process of port placement in the observation group were lower than the control group,and the difference was statistically significant(P<0.05);the complication rate of tube placement in the observation group was less than that of the control group.The complication rate of port placement was lower than that of the control group,and the difference was statistically significant(P<0.05).Conclusion Compared with the advantages of X-Ray radiography,intracavitary electrocardiography can effectively assist the implantation of the upper arm infusion port,reduce the time of successful port placement,maintenance time and the cost of port placement,improve the comfort of patients and reduce the incidence of complications,and the method is simple and easy to implement,with low therapeutic cost and high safety.