原发性肺癌患者经外周静脉置入中心静脉导管继发性异位的影响因素分析

Analysis of influencing factors on secondary ectopic placement of peripherally inserted central catheter in patients with primary lung cancer

目的:探讨原发性支气管肺癌患者经外周静脉置入中心静脉导管(PICC)尖端继发性异位的原因,为临床实践提供科学依据及指导。方法:回顾性收集山西医科大学第二医院呼吸与危重症医学科2022年1月—2023年12月收治的367例留置PICC原发性支气管肺癌患的临床资料,根据是否发生异位分为未异位组(n=331例)和异位组(n=36例),应用Logistic回归分析肺癌患者发生PICC导管继发性异位的危险因素。结果:在PICC导管使用中,异位组与未异位组在异位史、体质量指数(BMI)、指定维护地点、导管价位及护理人员置管工龄这五个方面比较,差异均有统计学意义(P<0.05)。结论:肺癌患者使用PICC导管时,易发生继发性异位,增加了并发症的发生风险(如导管堵塞、静脉血栓等),导致拔管、治疗延误、经济负担加重及生活质量下降。护理人员需高度重视并谨慎处理。

Objective:To explore and analyze the causes of secondary catheter ectopia at the tip of peripherally inserted central catheter(PICC)in patients with primary bronchogenic carcinoma.Methods:SPSS 26.0 software was used to perform statistical analysis on the data,rank sum test was used for inter group comparison of quantitative data,and logistic regression was used for multivariate analysis.From January 2022 to December 2023,among 367 primary bronchial lung cancer patients who received chemotherapy with PICC catheters in the respiratory and critical care medicine department of a tertiary hospital,36 patients developed secondary catheter ectopia.Results:There were statistically significant differences between the PICC ectopic group and the non ectopic group in terms of ectopic history,body mass index(BMI),designated maintenance site,catheter price,and nursing staff length of catheterization(P<0.05).Conclusion:There are many factors that can cause continuous catheter dislodgement during the use of PICC catheters in lung cancer patients.Ectopic catheters can significantly increase the incidence of other related complications,such as catheter blockage,venous thrombosis,pericardial effusion,arrhythmia,etc,ultimately leading to extubation,delayed treatment timing,increased economic burden on patients,and affecting their quality of life.Therefore,nursing staff should pay sufficient attention to secondary ectopic catheterization and handle it with caution.