BACKGROUND Peripherally inserted central catheters(PICCs)are an essential infusion route for oncology patients receiving intravenous treatments,but lower extremity veni-puncture is the preferred technique for patients...BACKGROUND Peripherally inserted central catheters(PICCs)are an essential infusion route for oncology patients receiving intravenous treatments,but lower extremity veni-puncture is the preferred technique for patients with superior vena cava syndrome(SVCS).We report the case of a patient with a lower extremity PICC ectopic to the ascending lumbar vein,to indicate and verify PICC catheterisation in the lower extremity is safe and feasible.And hope to provide different per-spectives for clinical PICC venipuncture to get the attention of peers.CASE SUMMARY On 24 August 2022,a 58-year-old male was admitted to our department due to an intermittent cough persisting for over a month,which worsened 10 d prior.Imaging and laboratory investigations suggested the patient with pulmonary malignancy and SVCS.Chemotherapy was not an absolute contraindication in this patient.Lower extremity venipuncture is the preferred technique because administering upper extremity venous transfusion to patients with SVCS can exacerbate oedema in the head,neck,and upper extremities.The patient and his family were informed about the procedure,and informed consent was obtained.After successful puncture and prompt treatment,the patient was discharged,experiencing some relief from symptoms.CONCLUSION Inferior vena cava catheterisation is rare and important for cancer patients with SVCS,particularly in complex situations involving ectopic placement.展开更多
Purpose: Research on clinical application effect of combining very low birth weight newborn (VLBWN) umbilical vein catheterization (UVC) with peripherally inserted central catheter (PICC). Method: 60 cases of VLBWN ch...Purpose: Research on clinical application effect of combining very low birth weight newborn (VLBWN) umbilical vein catheterization (UVC) with peripherally inserted central catheter (PICC). Method: 60 cases of VLBWN checked in our hospital’s ICU are selected and divided into combination group (n = 30) and PICC group (n = 30) according to the random number table. Combination of UVC and PICC is applied on newborn of combination group while only PICC is applied on newborn of PICC group. These two groups’ newborn’s PICC catheterization operation time, PICC indwelling time, weight gain, hospital stays, hospital infection, planned extubation, successful single puncture, adverse events and other indexes are observed. Result: Newborns in combination group have less PICC catheterization operation time and less hospital stays than newborns in PICC group while newborns in combination group have longer PICC indwelling time and greater weight gain than newborns in PICC group. The difference here has statistical significance (p < 0.05). Combination group’s hospital infection ratio (3.33%) is lower than that of PICC group (23.33%). The difference here has statistical significance (p < 0.05). Newborns in combination group have a planned extubation rate of 93.33% and a successful single puncture rate of 93.33%, which are greater than those of newborn in PICC group (respectively 73.33% and 70.00%). The difference here has statistical significance (p < 0.05). Newborns in combination group have an adverse event occurrence rate of 43.33%, lower than that of PICC group (70.00%). The difference here has statistical significance (p < 0.05). Conclusion: Application of combination of UVC and PICC on VLBWN can greatly improve PICC catheterization efficiency and newborn patients’ nutriture and reduce rate of complications, thus, it is worthy of clinical application.展开更多
Aims: To audit the use and outcomes of using PICC lines in hemato-oncological patients. Objectives: To study the demographics of patients: ?studying the use of PICC line in hemato-oncological patients;studying the rat...Aims: To audit the use and outcomes of using PICC lines in hemato-oncological patients. Objectives: To study the demographics of patients: ?studying the use of PICC line in hemato-oncological patients;studying the rate of complications in PICC line;studying the cause of early removal of PICC line. Methods: All PICCs inserted in adult hemato-oncological patients in Hematology and Medical Oncology Department of Health Care Global (HCG) Hospital were studied prospectively, as per the proforma, till PICCs were removed or patient expired and the pattern of complications were noted. Results: Eighty-four PICCs were inserted over a period of initial nine months and followed for a total of 1 year with three months post insertion duration for a total of 10,868 catheter-days (mean of 129 days i.e. 4.3 months, range: 1 to 288 days). The most common indication for PICC was chemotherapy (100%). Among them 19 (22%) PICCs had complications and 12 were removed at the rate of 1.1/1000 PICC-days. Complications with haematologic malignancies were more as compared to those with solid tissue malignancies. Conclusions: Despite significant complication rates, PICCs are a relatively safe and cost effective mode of establishing central venous access.展开更多
目的:分析超声引导腔内心电图技术对肿瘤患者经外周静脉穿刺中心静脉置管(peripherally inserted central venous catheters,PICC)一次性置管成功率与并发症的影响。方法:选取2021年6月—2022年12月于广西科技大学第二附属医院行PICC置...目的:分析超声引导腔内心电图技术对肿瘤患者经外周静脉穿刺中心静脉置管(peripherally inserted central venous catheters,PICC)一次性置管成功率与并发症的影响。方法:选取2021年6月—2022年12月于广西科技大学第二附属医院行PICC置管的肿瘤患者428例作为研究对象,按照随机数字表法将其分为对照组(214例)与研究组(214例)。两组患者均接受PICC置管,其中对照组采用超声引导置管,研究组采用超声引导腔内心电图技术置管。记录并比较两组患者PICC导管尖端到位率、置管异位率、一次性置管成功率、置管成功时间、视觉模拟评分法(VAS)评分、置管相关并发症发生情况及护理满意度。结果:研究组导管尖端到位率、置管异位率、一次性置管成功率均高于对照组,差异均有统计学意义(P<0.05)。研究组PICC置管成功时间短于对照组,差异有统计学意义(P<0.05);研究组VAS评分低于对照组,差异有统计学意义(P<0.05)。研究组PICC置管相关并发症发生率低于对照组,差异有统计学意义(P<0.05)。研究组护理总满意率高于对照组,差异有统计学意义(P<0.05)。结论:超声引导腔内心电图技术可以有效提高肿瘤患者PICC一次性置管成功率,降低并发症风险,适于临床应用及推广。展开更多
We aimed to study the appropriate posture of peripherally inserted central catheter （PICC） patients, to reduce the incidence of internal jugular vein heterotopia. Methods： From 2009 to 2013, a total of 290 cases wi...We aimed to study the appropriate posture of peripherally inserted central catheter （PICC） patients, to reduce the incidence of internal jugular vein heterotopia. Methods： From 2009 to 2013, a total of 290 cases with PICC were enrolled in our study. They were divided into two groups. The patients in control group took regular position, which mean pros- tration, upper limb of tube side was abduction 90°, head moved to puncture side in order to block the internal jugular vein. On the basis of conventional body position putting, posture of patients in observation group was improved, the head remain neutral, and had 180° angle with trunk longitudinal axis, not favor any side. After ensuring the upper limb abduction, had 90° angle with the trunk, then catheter was inserted slowly. The jugular venous catheter heterotopia rate was judged by X.ray results. Results： The jugular venous catheter heterotopia rate of control group and observation was 12.8% and 0.68%, respectively. The difference between two groups was statistically significant （P 〈 0.01）. Conclusion： The body posture improvement can prevent discomfort of patients and reduce the jugular venous catheter heterotopia rate of PICC.展开更多
目的探讨改良经外周静脉置入中心静脉导管(peripherally inserted central catheters,PICC)长度体外预测量方法的效果。方法选择2008年1月至2009年9月某院需行PICC的患者120例,按随机数字表将其分为对照组和观察组,每组各60例。观察组...目的探讨改良经外周静脉置入中心静脉导管(peripherally inserted central catheters,PICC)长度体外预测量方法的效果。方法选择2008年1月至2009年9月某院需行PICC的患者120例,按随机数字表将其分为对照组和观察组,每组各60例。观察组患者采用改良的体外测量法,即患者平卧位,外展手臂45°,采用从穿刺点至肩峰再由肩峰至右侧锁骨头的体外测量法。对照组患者采用常规体外测量法,即患者平卧位,外展手臂90°,采用从穿刺点至右胸锁关节再向下反折至第三肋间的体外测量法。比较两种体外测量方法的偏差率及不同测量方法对PICC置管位置的影响。结果应用改良法测量的偏差次数较少,观察组的偏差率明显低于对照组,差异有统计学意义(21.7%vs41.7%,χ2=5.55,P<0.05)。观察组患者PICC导管末端位置的准确率(95%)高于对照组(70%),差异有统计学意义(χ2=12.99,P<0.05)。结论改良的PICC体外测量方法可降低PICC置管体外预测量的客观和主观误差,有效提高PICC管置入上腔静脉的准确率,提高置管的准确性及安全性。展开更多
基金the Chongqing Medical Scientific Research Project(a joint project of the Chongqing Health Commission and Science and Technology Bureau),No.2020FYYX046。
文摘BACKGROUND Peripherally inserted central catheters(PICCs)are an essential infusion route for oncology patients receiving intravenous treatments,but lower extremity veni-puncture is the preferred technique for patients with superior vena cava syndrome(SVCS).We report the case of a patient with a lower extremity PICC ectopic to the ascending lumbar vein,to indicate and verify PICC catheterisation in the lower extremity is safe and feasible.And hope to provide different per-spectives for clinical PICC venipuncture to get the attention of peers.CASE SUMMARY On 24 August 2022,a 58-year-old male was admitted to our department due to an intermittent cough persisting for over a month,which worsened 10 d prior.Imaging and laboratory investigations suggested the patient with pulmonary malignancy and SVCS.Chemotherapy was not an absolute contraindication in this patient.Lower extremity venipuncture is the preferred technique because administering upper extremity venous transfusion to patients with SVCS can exacerbate oedema in the head,neck,and upper extremities.The patient and his family were informed about the procedure,and informed consent was obtained.After successful puncture and prompt treatment,the patient was discharged,experiencing some relief from symptoms.CONCLUSION Inferior vena cava catheterisation is rare and important for cancer patients with SVCS,particularly in complex situations involving ectopic placement.
文摘Purpose: Research on clinical application effect of combining very low birth weight newborn (VLBWN) umbilical vein catheterization (UVC) with peripherally inserted central catheter (PICC). Method: 60 cases of VLBWN checked in our hospital’s ICU are selected and divided into combination group (n = 30) and PICC group (n = 30) according to the random number table. Combination of UVC and PICC is applied on newborn of combination group while only PICC is applied on newborn of PICC group. These two groups’ newborn’s PICC catheterization operation time, PICC indwelling time, weight gain, hospital stays, hospital infection, planned extubation, successful single puncture, adverse events and other indexes are observed. Result: Newborns in combination group have less PICC catheterization operation time and less hospital stays than newborns in PICC group while newborns in combination group have longer PICC indwelling time and greater weight gain than newborns in PICC group. The difference here has statistical significance (p < 0.05). Combination group’s hospital infection ratio (3.33%) is lower than that of PICC group (23.33%). The difference here has statistical significance (p < 0.05). Newborns in combination group have a planned extubation rate of 93.33% and a successful single puncture rate of 93.33%, which are greater than those of newborn in PICC group (respectively 73.33% and 70.00%). The difference here has statistical significance (p < 0.05). Newborns in combination group have an adverse event occurrence rate of 43.33%, lower than that of PICC group (70.00%). The difference here has statistical significance (p < 0.05). Conclusion: Application of combination of UVC and PICC on VLBWN can greatly improve PICC catheterization efficiency and newborn patients’ nutriture and reduce rate of complications, thus, it is worthy of clinical application.
文摘Aims: To audit the use and outcomes of using PICC lines in hemato-oncological patients. Objectives: To study the demographics of patients: ?studying the use of PICC line in hemato-oncological patients;studying the rate of complications in PICC line;studying the cause of early removal of PICC line. Methods: All PICCs inserted in adult hemato-oncological patients in Hematology and Medical Oncology Department of Health Care Global (HCG) Hospital were studied prospectively, as per the proforma, till PICCs were removed or patient expired and the pattern of complications were noted. Results: Eighty-four PICCs were inserted over a period of initial nine months and followed for a total of 1 year with three months post insertion duration for a total of 10,868 catheter-days (mean of 129 days i.e. 4.3 months, range: 1 to 288 days). The most common indication for PICC was chemotherapy (100%). Among them 19 (22%) PICCs had complications and 12 were removed at the rate of 1.1/1000 PICC-days. Complications with haematologic malignancies were more as compared to those with solid tissue malignancies. Conclusions: Despite significant complication rates, PICCs are a relatively safe and cost effective mode of establishing central venous access.
文摘目的:分析超声引导腔内心电图技术对肿瘤患者经外周静脉穿刺中心静脉置管(peripherally inserted central venous catheters,PICC)一次性置管成功率与并发症的影响。方法:选取2021年6月—2022年12月于广西科技大学第二附属医院行PICC置管的肿瘤患者428例作为研究对象,按照随机数字表法将其分为对照组(214例)与研究组(214例)。两组患者均接受PICC置管,其中对照组采用超声引导置管,研究组采用超声引导腔内心电图技术置管。记录并比较两组患者PICC导管尖端到位率、置管异位率、一次性置管成功率、置管成功时间、视觉模拟评分法(VAS)评分、置管相关并发症发生情况及护理满意度。结果:研究组导管尖端到位率、置管异位率、一次性置管成功率均高于对照组,差异均有统计学意义(P<0.05)。研究组PICC置管成功时间短于对照组,差异有统计学意义(P<0.05);研究组VAS评分低于对照组,差异有统计学意义(P<0.05)。研究组PICC置管相关并发症发生率低于对照组,差异有统计学意义(P<0.05)。研究组护理总满意率高于对照组,差异有统计学意义(P<0.05)。结论:超声引导腔内心电图技术可以有效提高肿瘤患者PICC一次性置管成功率,降低并发症风险,适于临床应用及推广。
文摘We aimed to study the appropriate posture of peripherally inserted central catheter （PICC） patients, to reduce the incidence of internal jugular vein heterotopia. Methods： From 2009 to 2013, a total of 290 cases with PICC were enrolled in our study. They were divided into two groups. The patients in control group took regular position, which mean pros- tration, upper limb of tube side was abduction 90°, head moved to puncture side in order to block the internal jugular vein. On the basis of conventional body position putting, posture of patients in observation group was improved, the head remain neutral, and had 180° angle with trunk longitudinal axis, not favor any side. After ensuring the upper limb abduction, had 90° angle with the trunk, then catheter was inserted slowly. The jugular venous catheter heterotopia rate was judged by X.ray results. Results： The jugular venous catheter heterotopia rate of control group and observation was 12.8% and 0.68%, respectively. The difference between two groups was statistically significant （P 〈 0.01）. Conclusion： The body posture improvement can prevent discomfort of patients and reduce the jugular venous catheter heterotopia rate of PICC.
文摘目的探讨改良经外周静脉置入中心静脉导管(peripherally inserted central catheters,PICC)长度体外预测量方法的效果。方法选择2008年1月至2009年9月某院需行PICC的患者120例,按随机数字表将其分为对照组和观察组,每组各60例。观察组患者采用改良的体外测量法,即患者平卧位,外展手臂45°,采用从穿刺点至肩峰再由肩峰至右侧锁骨头的体外测量法。对照组患者采用常规体外测量法,即患者平卧位,外展手臂90°,采用从穿刺点至右胸锁关节再向下反折至第三肋间的体外测量法。比较两种体外测量方法的偏差率及不同测量方法对PICC置管位置的影响。结果应用改良法测量的偏差次数较少,观察组的偏差率明显低于对照组,差异有统计学意义(21.7%vs41.7%,χ2=5.55,P<0.05)。观察组患者PICC导管末端位置的准确率(95%)高于对照组(70%),差异有统计学意义(χ2=12.99,P<0.05)。结论改良的PICC体外测量方法可降低PICC置管体外预测量的客观和主观误差,有效提高PICC管置入上腔静脉的准确率,提高置管的准确性及安全性。
