Use of endoscopic ultrasound-guided gallbladder drainage as a rescue approach in cases of unsuccessful biliary drainage

This narrative review provides an overview of the utilization of endoscopic ultrasound-guided gallbladder drainage(EUS-GBD)as a salvage approach in cases of unsuccessful conventional management.EUS-GBD is a minimally invasive and effective technique for drainage in patients with acute cholecystitis with high risk of surgery.The procedure has demonstrated impressive technical and clinical success rates with low rates of adverse events,making it a safe and effective option for appropriate candidates.Furthermore,EUS-GBD can also serve as a rescue option for patients who have failed endoscopic retrograde cholangiopancreatography or EUS biliary drainage for relief of jaundice in malignant biliary stricture.However,patient selection is critical for the success of EUS-GBD,and proper patient selection and risk assessment are important to ensure the safety and efficacy of the procedure.As the field continues to evolve and mature,ongoing research will further refine our understanding of the benefits and limitations of EUS-GBD,ultimately leading to improved outcomes for patients.

Endoscopic ultrasound-guided gastroenterostomy for gastric outlet obstruction in Mexico

BACKGROUND Endoscopic ultrasound-guided gastroenterostomy(EUS-GE)has recently emerged as an alternative treatment for gastric outlet obstruction(GOO)in selected patients.AIM To report the initial experience of EUS-GE in patients with GOO.METHODS This study was a retrospective,observational,multicenter study in which the data from 10 patients who underwent EUS-GE due to GOO between September 2021 and May 2023 were collected.We analyzed technical success,clinical success,adverse events,and survival.Technical success was defined as adequate positioning and deployment of the stent.Clinical success was defined as the patient’s ability to tolerate oral intake without vomiting 7 d after the procedure.Postprocedural adverse events were recorded.RESULTS Eleven procedures in 10 patients with GOO were included.The mean age of the patients was 67.5 years(range:56-77 years).Malignant GOO was present in 9 patients.Technical success was achieved in 9/11 procedures(82%).Among them,clinical success was achieved in 9 patients(100%).Adverse events occurred in 1 patient(9%).The median survival was 3 months(n=7;range:1-8 months).CONCLUSION EUS-GE is a feasible therapeutic option in the treatment of GOO.

Ultrasound-guided fascia iliaca compartment block combined with general anesthesia for amputation in an acute myocardial infarction patient after percutaneous coronary intervention: A case report

BACKGROUND Fascia iliaca compartment block is a technique that blocks three nerves,similar to a 3-in-1 nerve block.This block provides analgesia for patients undergoing lower limb surgery,and is a simple technique that is easy to implement.Here,we report a case of fascia iliaca compartment block in a patient with myocardial infarction who underwent emergency middle thigh amputation.CASE SUMMARY A 78-year-old female patient weighing 38 kg with gangrene and occlusive peripheral atherosclerosis of the right leg underwent an emergency middle thigh amputation.The patient had a history of hypertension,coronary heart disease,cerebral infarction,anterior wall myocardial infarction,and had recently undergone percutaneous coronary intervention consisting of coronary angiography and right coronary artery stent implantation.Considering the patient's condition,an ultrasound-guided fascia iliaca compartment block combined with general anesthesia was implemented for amputation.The fascia iliaca compartment block provided analgesia for the operation,and reduced the dosage of general anesthetics.It also alleviated adverse cardiovascular effects caused by pain stress,and ensured the safety of the patient during the perioperative period.This block also provided postoperative analgesia.The patient had a good prognosis,and was subsequently discharged from hospital.CONCLUSION Fascia iliaca compartment block provides surgical analgesia.It also alleviates adverse cardiovascular effects,and ensures patient safety during the perioperative period.

Comprehensive review on endoscopic ultrasound-guided tissue acquisition techniques for solid pancreatic tumor

Pancreatic ductal adenocarcinoma is speculated to become the second leading cause of cancer-related mortality by 2030,a high mortality rate considering the number of cases.Surgery and chemotherapy are the main treatment options,but they are burdensome for patients.A clear histological diagnosis is needed to determine a treatment plan,and endoscopic ultrasound(EUS)-guided tissue acquisition(TA)is a suitable technique that does not worsen the cancer-specific prognosis even for lesions at risk of needle tract seeding.With the development of personalized medicine and precision treatment,there has been an increasing demand to increase cell counts and collect specimens while preserving tissue structure,leading to the development of the fine-needle biopsy(FNB)needle.EUS-FNB is rapidly replacing EUS-guided fine-needle aspiration(FNA)as the procedure of choice for EUS-TA of pancreatic cancer.However,EUS-FNA is sometimes necessary where the FNB needle cannot penetrate small hard lesions,so it is important clinicians are familiar with both.Given these recent developments,we present an up-to-date review of the role of EUS-TA in pancreatic cancer.Particularly,technical aspects,such as needle caliber,negative pressure,and puncture methods,for obtaining an adequate specimen in EUS-TA are discussed.

Interventional endoscopic ultrasound:Therapeutic capability and potential

The linear echoendoscope,introduced in the 1990s,opened the era of interventional endoscopic ultrasound(IEUS).The linear echoendoscope enabled EUS guided Fine Needle Aspiration(EUS-FNA) allowing the path of the needle to be traced during the puncture process.After EUS-FNA,other interventional procedures were introduced in clinical practice.Tissue acquisition was the first EUS-guided interventional procedure and its higher diagnostic quality has undoubtedly been established.After EUS-FNA,Celiac plexus neurolysis(CPN) and block(CPB),pancreatic pseudocyst drainage,abdominal and mediastinal collections/abscesses drainage,and in selected cases,pancreatic and biliary ductal system drainage,were introduced in clinical practice.EUS-guided fine needle injection with local delivery of antitumor agents is considered a promising modality.We have reviewed published data on EUS guided interventional procedures with the object of summarizing the diagnostic capability of endoscopic ultrasound and elaborates in detail its therapeutic capability and potential.

Endoscopic ultrasound guided interventions in the management of pancreatic cancer

There has been a growing interest in developing endoscopic ultrasound(EUS)-guided interventions for pancreatic cancer,some of which have become standard of care.There are two main factors that drive these advancements to facilitate treatment of patients with pancreatic cancer,ranging from direct locoregional therapy to palliation of symptoms related to inoperable pancreatic cancer.Firstly,an upper EUS has the capability to access the entire pancreas–lesions in the pancreatic head and uncinate process can be accessed from the duodenum,and lesions in the pancreatic body and tail can be accessed from the stomach.Secondly,there has been a robust development of devices that allow through-theneedle interventions,such as placement of fiducial markers,brachytherapy,intratumoral injection,gastroenterostomy creation,and ablation.While these techniques are rapidly emerging,data from a multicenter randomized controlled trial for some procedures are awaited prior to their adoption in clinical settings.

Clinical utility of treatment method conversion during single-session endoscopic ultrasound-guided biliary drainage

BACKGROUND Although several techniques for endoscopic ultrasound-guided biliary drainage(EUS-BD)are available at present,an optimal treatment algorithm of EUS-BD has not yet been established.AIM To evaluate the clinical utility of treatment method conversion during single endoscopic sessions for difficult cases in initially planned EUS-BD.METHODS This was a single-center retrospective analysis using a prospectively accumulated database.Patients with biliary obstruction undergoing EUS-BD between May 2008 and April 2016 were included.The primary outcome was to evaluate the improvement in EUS-BD success rates by converting the treatment methods during a single endoscopic session.Secondary outcomes were clarification of the factors leading to the conversion from the initial EUS-BD and the assessment of efficacy and safety of the conversion as judged by technical success,clinical success,and adverse events(AEs).RESULTS A total of 208 patients underwent EUS-BD during the study period.For 18.8%(39/208)of the patients,the treatment methods were converted to another EUSBD technique from the initial plan.Biliary obstruction was caused by pancreatobiliary malignancies,other malignant lesions,biliary stones,and other benign lesions in 22,11,4,and 2 patients,respectively.The reasons for the difficulty with the initial EUS-BD were classified into the following 3 procedures:Target puncture(n=13),guidewire manipulation(n=18),and puncture tract dilation(n=8).Technical success was achieved in 97.4%(38/39)of the cases and clinical success was achieved in 89.5%of patients(34/38).AEs occurred in 10.3%of patients,including bile leakage(n=2),bleeding(n=1),and cholecystitis(n=1).The puncture target and drainage technique were altered in subsequent EUSBD procedures in 25 and 14 patients,respectively.The final technical success rate with 95%CI for all 208 cases was 97.1%(95%CI:93.8%-98.9%),while that of the initially planned EUS-BD was 78.8%(95%CI:72.6%-84.2%).CONCLUSION Among multi-step procedures in EUS-BD,guidewire manipulation appeared to be the most technically challenging.When initially planned EUS-BD is technically difficult,treatment method conversion in a single endoscopic session may result in successful EUS-BD without leading to severe AEs.

Endoscopic ultrasound-guided fiducial marker placement for neoadjuvant chemoradiation therapy for resectable pancreatic cancer

BACKGROUND Preoperative neoadjuvant chemoradiation therapy(NACRT)is applied for resectable pancreatic cancer(RPC).To maximize the efficacy of NACRT,it is essential to ensure the accurate placement of fiducial markers for image-guided radiation.However,no standard method for delivering fiducial markers has been established to date,and the nature of RPC during NACRT remains unclear.AIM To determine the feasibility,safety and benefits of endoscopic ultrasound-guided(EUS)fiducial marker placement in patients with RPC.METHODS This was a prospective case series of 29 patients(mean age,67.5 years;62.1%male)with RPC referred to our facility for NACRT.Under EUS guidance,a single gold marker was placed into the tumor using either a 19-or 22-gauge fine-needle aspiration needle.The differences in daily marker positioning were measured by comparing simulation computed tomography and treatment computed tomography.RESULTS In all 29 patients(100%)who underwent EUS fiducial marker placement,fiducials were placed successfully with only minor,self-limiting bleeding during puncture observed in 2 patients(6.9%).NACRT was subsequently administered to all patients and completed in 28/29(96.6%)cases,with one patient experiencing repeat cholangitis.Spontaneous migration of gold markers was observed in 1 patient.Twenty-four patients(82.8%)had surgery with 91.7%(22/24)R0 resection,and two patients experienced complete remission.No inflammatory changes around the marker were observed in the surgical specimen.The daily position of gold markers showed large positional changes,particularly in the superior-inferior direction.Moreover,tumor location was affected by food and fluid intake as well as bowel gas,which changes daily.CONCLUSION EUS fiducial marker placement following NACRT for RPC is feasible and safe.The RPC is mobile and is affected by not only aspiration,but also food and fluid intake and bowel condition.

Meta分析经股动脉穿刺介入术后穿刺部位出血的危险因素

目的探讨股动脉穿刺介入术后穿刺部位出血的危险因素。方法检索从建库至2022年12月31日中国知网、万方、维普、中国生物医学文献服务系统数据库(CBM)、PubMed、Medline、The Cochrane Library、EMbase、Web of Science数据库中关于经股动脉穿刺介入术后穿刺部位出血危险因素的观察性研究,包括横断面研究、病例对照和队列研究文献。采用Newcastle-Ottawa量表(NOS)评分对纳入研究的文献质量进行评价,应用RevMan 5.3软件对文献数据进行Meta分析。结果最终纳入文献8篇(总样本量35250例),术后出血组患者1410例,非出血组33840例。Meta分析结果显示,高龄(OR=2.71,95%CI=2.17~3.38)、女性(OR=4.26,95%CI=1.08~16.89)、高血压(OR=2.48,95%CI=1.69~3.63)、肥胖(OR=2.33,95%CI=1.59~3.42)、使用溶栓剂/抗凝剂/血小板拮抗剂(OR=2.95,95%CI=2.24~3.89)、人工按压(OR=6.78,95%CI=1.34~34.43)是股动脉穿刺介入术后穿刺部位出血的危险因素。结论高龄、女性、高血压、肥胖、使用溶栓剂/抗凝剂/血小板拮抗剂、人工按压是股动脉穿刺介入术后穿刺部位出血的危险因素。

自制乳腺肿物模型训练法在超声导丝定位穿刺实践教学中的效果评价

目的探究自制乳腺肿物穿刺模型在临床超声介入教学中的应用效果。方法选取2021年1月—2022年12月黑龙江中医药大学附属第二医院超声影像学专业及康复医学专业的50名规培生为研究对象,按照不同规培时间将其分为研究组和对照组,每组25名,其中对照组规培时间为2021年1—12月,研究组规培时间为2022年1—12月。对照组规培生予传统教学法,即课堂理论教学结合高强度琼脂乳腺教学模型进行训练;研究组规培生在课堂理论教学的基础上再结合自制乳腺肿物模型实操训练;待学习结束后统一对两组规培生进行理论及实践考核以及学习满意度调查,比较对照组及研究组的学习结果。结果两组规培生的理论考核成绩差异比较,差异无统计学意义(P>0.05)。研究组规培生的操作考核成绩明显高于对照组学生,差异有统计学意义(P<0.05)。研究组规培生在增强操作技能、激发理论兴趣、丰富教学内容等各个方面评分均有较高的满意度,且显著高于对照组,差异有统计学意义(P均<0.05)。结论自制乳腺肿物穿刺模型能使学生更好地将超声介入技术应用于今后的临床操作中,有效提高教师的临床教学质量及学生的超声穿刺水平。

超声引导下穿刺介入治疗与腹腔镜下开窗引流术在肝囊肿患者中的应用效果分析

目的分析在肝囊肿患者中实施超声引导下穿刺介入治疗与腹腔镜下开窗引流术的效果。方法简单随机选取2022年1月—2023年9月烟台市烟台山医院收治的40例肝囊肿患者为研究对象,以随机数表法将其分为对照组、研究组,各20例。对照组行腹腔镜下开窗引流术,研究组行超声引导下穿刺介入治疗。比较两组患者胃肠道功能指标、肝功能指标和并发症发生率。结果研究组各项术后恢复时间均短于对照组,差异有统计学意义(P均<0.05)。手术后,研究组患者肝功能均优于对照组,差异有统计学意义(P<0.05)。研究组并发症发生率为10.00%,低于对照组的35.00%,差异有统计学意义(χ^(2)=5.291,P<0.05)。结论超声引导下穿刺介入治疗肝囊肿,患者胃肠道功能指标、肝功能指标更优,并发症发生率更低。

远端桡动脉途径和传统桡动脉途径穿刺对脑血管介入诊疗患者疼痛程度的影响比较

目的探讨远端桡动脉途径(dTRA)和传统桡动脉途径(cTRA)穿刺对脑血管介入诊疗患者疼痛程度的影响差异。方法选取2022年8月至2023年3月于首都医科大学附属北京安贞医院脑血管病科行脑血管介入诊疗的患者90例。根据操作方式的不同将患者分为cTRA组和dTRA组。使用数字评定量表(NRS)对患者术后的疼痛程度进行评估,比较2组危险因素、实验室检查指标、NRS评分以及穿刺并发症发生情况和围术期不良事件发生情况。结果cTRA组57例,dTRA组33例。除饮酒比例、冠心病(冠状动脉粥样硬化性心脏病)比例、血糖水平外,2组危险因素、实验室检查指标差异均无统计学意义(均P>0.05)。2组均未出现NRS评分高于5分者,dTRA组内疼痛评分低的患者比例较高。dTRA组NRS评分低于cTRA组[0(0,0.5)分比2.0(1.0,3.0)分],差异有统计学意义(Z=6.300,P<0.001)。2组穿刺点发绀发生率差异无统计学意义(P>0.05),2组围术期均无脑出血、脑梗死、心肌梗死等不良事件发生。结论相对于cTRA穿刺而言,脑血管介入患者选择dTRA穿刺能减轻疼痛程度,且不增加并发症。

介入超声经皮穿刺活检技术在鉴别乳腺肿瘤良恶性中的应用效果

目的:分析介入超声经皮穿刺活检技术在鉴别乳腺肿瘤良恶性中的应用效果。方法:选取2021年1月—2023年12月泰州市第四人民医院收治的乳腺肿瘤患者62例为研究对象。患者均接受常规超声与介入超声经皮穿刺活检技术进行诊断。以病理学诊断结果为“金标准”,比较常规超声与介入超声经皮穿刺活检技术的灵敏度、特异度、准确率。结果:病理学诊断结果显示,良性乳腺肿瘤患者32例,占比51.61%,恶性肿瘤患者30例,占比48.39%。介入超声经皮穿刺活检术检查灵敏度及准确率高于常规超声检查,差异有统计学意义(P<0.05);两种检查方法特异度比较,差异无统计学意义(P>0.05)。结论:介入超声经皮穿刺活检术在鉴别乳腺肿瘤良恶性中的效果较好,可提高灵敏度和准确率。

皮下“Z”字缝合在心血管疾病大口径鞘管介入术后股静脉穿刺点止血中的应用

目的评价皮下“Z”字缝合用于大口径鞘管撤除后股静脉穿刺点止血的安全性和有效性。方法选取2020年5月至2021年12月海军军医大学(第二军医大学)第一附属医院收治的263例行心房颤动冷冻消融或无导线心脏起搏器植入术的患者。心房颤动冷冻消融患者使用外径为16F的鞘管,无导线起搏器植入患者使用外径为27F的鞘管。采用信封法按照1∶1的比例将患者随机分为两组,分别通过“8”字缝合(132例)和皮下“Z”字缝合(131例)2种方式对股静脉穿刺点止血,比较两组患者的缝合操作时间、止血效果、并发症发生率及患者舒适度。结果两组患者的缝合操作时间、即刻止血成功率及并发症发生率差异均无统计学意义(均P>0.05)。皮下“Z”字缝合组术后Kolcaba的舒适状况量表的生理维度得分[(17.8±1.6)分vs(12.7±2.2)分]、心理维度得分[(33.1±2.7)分vs(26.4±3.5)分]及总分[(84.2±3.4)分vs(73.5±5.6)分]均高于“8”字缝合组,差异有统计学意义(均P<0.05)。结论皮下“Z”字缝合可实现大口径鞘管撤除后股静脉穿刺点的安全和有效止血,且患者的舒适度优于“8”字缝合。

赛丁格技术的应用及研究进展

赛丁格技术是一种在医学领域广泛应用的介入操作技术,它通过穿刺、导丝插入和导管置入等步骤,实现了血管内插管的安全有效。赛丁格技术在中心静脉置管、动脉导管插管、血管介入治疗以及脏器穿刺置管等多个领域具有重要应用,具有操作简便、并发症风险低、操作灵活性强等特点。本文对赛丁格技术的发展历程、国内外应用现状以及优劣势做一综述,以期为医学介入操作的应用提供参考。

基于奥马哈理论围手术期全程康复护理对心血管介入治疗患者的影响

目的探究基于奥马哈理论的围手术期全程康复护理对经远端桡动脉途径行心血管介入治疗患者的影响。方法回顾性选取2020年3月到2023年3月期间连云港市中医院收治的70例经远端桡动脉途径行心血管介入治疗患者,根据护理方法不同分为对照组与观察组,各35例。对照组中,男19例,女16例,年龄(62.92±2.58)岁,实施常规护理干预;观察组中,男20例,女15例,年龄(63.18±2.18)岁,实施基于奥马哈理论的围手术期全程康复护理干预。比较两组穿刺情况(一次穿刺成功、穿刺时间、桡动脉痉挛、局部血肿、桡动脉闭塞)、穿刺成功率(植入支架、药物球囊扩张、成功率)及负面情绪[采用焦虑自评量表(Self-Rating Anxiety Scale,SAS)、抑郁自评量表(Self-Rating Depression Scale,SDS)评估]。采用χ2检验、t检验进行统计分析。结果观察组一次穿刺成功人数(34/35,97.1%)高于对照组(21/35,60.0%);观察组穿刺时间为(4.17±0.17)min、桡动脉痉挛5.7%(2/35)、局部血肿2.9%(1/35)、桡动脉闭塞2.9%(1/35),对照组分别为(5.86±0.63)min、34.3%(12/35)、25.7%(9/35)、31.4%(11/35);两组比较差异均有统计学意义(均P<0.05)。观察组植入支架(1/35,2.9%)、药物球囊扩张人数(2/35,5.7%)均少于对照组[(9/35,25.7%)、(12/35,34.3%)],穿刺成功率(97.1%,34/35)高于对照组(62.9%,22/35),差异均有统计学意义(均P<0.05)。护理后3 d,观察组患者的SAS评分为(40.48±4.84)分、SDS评分为(43.67±4.91)分,均低于对照组[(48.12±4.18)分、(49.34±5.27)分],两组比较差异均有统计学意义(均P<0.001)。结论基于奥马哈理论的围手术期全程康复护理可以提高经远端桡动脉途径行心血管介入治疗患者的穿刺成功率,降低负面情绪。

母乳嗅觉刺激联合音乐干预对静脉穿刺新生儿镇痛及穿刺成功率的影响

目的:探讨母乳嗅觉刺激联合音乐干预对静脉穿刺新生儿镇痛及穿刺成功率的影响。方法:选取2021年12月-2023年12月于本院行静脉穿刺的新生儿102例,分为观察组和对照组各51例,两组均给予常规静脉穿刺方法,观察组同时给予母乳嗅觉刺激联合音乐干预。比较两组新生儿疼痛评估量表(NIPS)评分、新生儿面部编码系统(NFCS)评分、新生儿哭闹开始时间和持续时间、一次穿刺成功率、心率(HR)、血氧饱和度(SpO_(2))和穿刺相关并发症。结果:观察组穿刺中、穿刺1 min和2 min后的NIPS评分(4.83±0.74分、2.35±0.67分、0.78±0.40分)、NFCS评分(5.02±1.14分、3.18±0.75分、1.04±0.33分)、哭闹持续时间(54.3±7.2s)、HR(148.1±4.9次/min、149.3±4.8次/min、142.1±4.2次/min)、穿刺相关并发症发生率(5.9%)均低于对照组(5.32±0.88分、3.49±0.56分、1.43±0.47分、5.78±1.09分、4.22±0.93分、1.51±0.48分、110.82±12.28 s、153.8±5.2次/min、155.4±4.9次/min、146.3±4.2次/min、19.6%),新生儿哭闹开始时间(2.8±0.4 s)晚于对照组(2.1±0.2 s),一次穿刺成功率(96.1%)及穿刺中、穿刺1 min和2 min后的SpO_(2)(95.8%±1.9%、95.2%±1.8%、95.0%±1.7%)均高于对照组(82.4%、94.5%±1.7%、94.0%±1.6%、93.6%±1.6%)(均P<0.05)。结论:母乳嗅觉刺激联合音乐干预可有效减轻新生儿对静脉穿刺的疼痛感知,减少新生儿的哭闹时间,有利于提高一次穿刺成功率,降低穿刺相关并发症风险。

经桡动脉入径行经皮冠脉介入术后不同穿刺点压迫时间对疼痛及并发症的影响

目的:探讨经桡动脉入路行经皮冠脉介入术(PCI)后穿刺点最佳压迫时间。方法:选择2023年1—5月厦门大学附属心血管病医院收治的210例行桡动脉路径行PCI的患者为研究对象,按照信封法分为4 h组(71例)、5 h组(70例)和6 h组(69例)。三组分别为术后桡动脉穿刺口压迫4、5、6 h。比较三组疼痛程度和并发症发生情况。结果:三组穿刺点疼痛评分比较,差异有统计学意义(P<0.001);4 h组疼痛评分低于5 h组、6 h组(P<0.001),5 h组患者疼痛评分低于6 h组,差异均有统计学意义(P=0.004)。三组穿刺部位不同压迫时间对出血、血肿、水疱、迷走神经反射、前臂肿胀程度等并发症无影响,差异均无统计学意义(P>0.05)。结论:经桡动脉入径行PCI后穿刺点最佳压迫时间为4 h。

护理管理干预对小儿静脉一次穿刺成功率的影响因素

目的探究护理管理干预对小儿静脉穿刺成功率的影响。方法选取2021年1月1日—2021年3月30日我院700例6岁以内通过静脉穿刺治疗的患儿作为研究对象,抽签法分为对照组(常规护理,350例)和观察组(护理管理干预,350例),对比两组穿刺成功情况、家属满意度、并发症发生情况以及护理质量评分。结果观察组一次穿刺成功率(81.43%)高于对照组(59.71%)(P<0.05);观察组护理满意度为99.43%,高于对照组的93.71%(P<0.05);观察组并发症总发生率低于对照组(3.43%vs.9.71%)(P<0.05);观察组基础护理、护理安全、操作技能、服务态度等各项护理质量评分对比对照组均更高(均P<0.05)。结论在小儿静脉穿刺护理中采取护理管理干预有利于提升一次穿刺成功率,降低并发症发生率,能够使患儿家属对于护理服务更加满意。

集束化干预在老年肿瘤患者经外周静脉穿刺中心静脉置管中的应用

目的探讨集束化干预在老年肿瘤患者经外周静脉穿刺中心静脉置管(central venous catheterization through peripheral venous puncture,PICC)中的应用。方法回顾性分析2021年10月—2022年10月在三六三医院收治的首次行PICC置管的135例老年肿瘤患者的临床资料,根据不同干预方法将其分为观察组(n=94)和常规组(n=41)。观察组采取集束化干预,常规组患者给予常规干预。观察并比较2组PICC情况(时长、穿刺次数),干预期间并发症[置管部位医用粘胶剂相关性皮肤损伤(MARSI)、导管局部感染、相关血栓形成、静脉炎和非计划拔管]发生情况,以及干预结束后患者的护理满意度和舒适度评分;采用健康调查量表SF-36评分评价并比较2组患者干预前后的生活质量水平。结果与常规组比较,观察组1次穿刺成功率升高,PICC导管留置时长增加,差异均有统计学意义(P<0.05);干预期间,观察组总并发症发生率低于常规组(P<0.05);干预后,观察组护理满意度评分、舒适度评分、SF-36各维度评分及其干预前后差值绝对值均高于常规组(P<0.05)。结论集束化干预技术应用于老年肿瘤患者的PICC置管,优势明显,有助于降低置管后并发症的发生率,提高首次穿刺成功率,延长置管时间,并改善患者的舒适度和满意度,具有一定的临床应用价值。