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
目的探讨末端瓣膜耐高压注射型经外周静脉穿刺中心静脉置管(application of power peripherally inserted central catheter solo,Power PICC Solo)与经锁骨下中心静脉置管(central venous catheter,CVC)在造血干细胞移植患者中的应用...目的探讨末端瓣膜耐高压注射型经外周静脉穿刺中心静脉置管(application of power peripherally inserted central catheter solo,Power PICC Solo)与经锁骨下中心静脉置管(central venous catheter,CVC)在造血干细胞移植患者中的应用。方法选取2021年9月—2023年6月厦门大学附属第一医院收治的100例造血干细胞移植患者。根据患者置管方法分为外周静脉穿刺中心静脉置管(peripherally inserted central catheter,PICC)组(n=58)和CVC组(n=42),PICC组采用Power PICC Solo,CVC组采用CVC。比较2组患者的置管成功情况、操作时间、导管置留时间、置管费用、置管后舒适度、患者液体流速、并发症发生率、患者满意度。结果PICC组置管成功率优于CVC组,差异有统计学意义(P<0.05)。PICC组操作时间短于CVC组,导管置留时间长于CVC组,置管费用高于CVC组,差异有统计学意义(P<0.05)。PICC组患者舒适度优于CVC组,差异有统计学意义(P<0.05)。在置管后第1、10、20、30天,PICC组患者液体流速均低于CVC组,且2组患者置管后第30天流速均低于置管后第1天,差异有统计学意义(P<0.05)。PICC组患者血栓性静脉炎发生率高于CVC组,导管感染发生率低于CVC组,差异有统计学意义(P<0.05),2组患者血气胸、导管异位、导管脱落等发生率比较,差异无统计学意义(P>0.05)。PICC组操作技术满意度评分为(17.24±2.17)分,高于CVC组的(14.07±2.68)分,差异有统计学意义(P<0.05)。结论与CVC比较,Power PICC Solo能够提高造血干细胞移植患者一次置管成功率,降低置管操作时间,延长导管置留时间,提高患者置管后舒适度,但置管费用较高,且血栓性静脉炎发生率高。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
目的总结血液肿瘤患者PICC相关并发症预防的最佳证据,为临床实践提供参考。方法系统检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、医脉通、美国国立指南库、英国国家卫生与临床优化研究所网站、乔安娜布里格斯研究所...目的总结血液肿瘤患者PICC相关并发症预防的最佳证据,为临床实践提供参考。方法系统检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、医脉通、美国国立指南库、英国国家卫生与临床优化研究所网站、乔安娜布里格斯研究所(JBI)数据库、国际指南协作网、苏格兰校际指南网站、WHO网站、BMJ、Up To Date、Embase、PubMed、Web of Science、Cochrane Library关于血液科肿瘤患者PICC并发症预防的相关文献,检索时间为建库至2022年6月30日,对符合纳入排除标准的文献进行质量评价、证据分级及整合。结果最终纳入11篇文献,其中指南3篇、系统评价3篇、干预性研究2篇、专家共识3篇,总结出包括PICC评估与管理、置管前预防、置管中预防、置管后预防和健康教育5个方面的31条证据。结论本研究总结的血液肿瘤患者PICC相关并发症预防的最佳证据具有良好的科学性和系统性,可为提高患者治疗效果、减轻其经济负担提供循证依据,但应结合临床现况,针对性地运用最佳证据。展开更多
目的:系统检索国内外经外周置入中心静脉导管(PICC)相关性血栓风险预测模型的研究并对其基本特征、建模过程、预测性能和验证方法等进行分析和评价。方法:在PubMed、EMbase、Web of Science、万方、维普和知网等数据库检索相关研究,由2...目的:系统检索国内外经外周置入中心静脉导管(PICC)相关性血栓风险预测模型的研究并对其基本特征、建模过程、预测性能和验证方法等进行分析和评价。方法:在PubMed、EMbase、Web of Science、万方、维普和知网等数据库检索相关研究,由2名研究者独立进行文献筛选和文献资料提取,并根据PROBAST工具对纳入研究进行质量评价。结果:共纳入13个PICC相关性血栓风险预测模型,建模人群以肿瘤病人为主(n=7);11个模型报道了其预测性能,受试者工作特征(ROC)曲线下面积(AUC)值或C指数为0.64~0.89;5个模型进行了内部验证,4个模型进行了外部验证。质量评价结果为1个低偏倚风险和12个高偏倚风险。预测模型中最常见且赋值较高的预测因子包括化疗史、血栓史、糖尿病、肥胖或体质指数(BMI)≥25 kg/m2、导管尖端位置异位/非最佳位置及白细胞计数升高等。结论:现有研究表明,PICC相关性血栓风险预测模型预测准确度较高,但整体研究质量偏低,仍需从模型构建过程、模型验证和结果报告等方面进一步优化,以便为临床医务工作者提供可早期识别PICC相关性血栓高危人群的可靠的、科学的评估工具。展开更多
OBJECTIVE: To calculate and compare the cost of Port and PICC's application in long-term intravenous administration, and to support the decision making of hospital manager. METHODS: Literature review and patient s...OBJECTIVE: To calculate and compare the cost of Port and PICC's application in long-term intravenous administration, and to support the decision making of hospital manager. METHODS: Literature review and patient survey in 2 oncology centers in China were carried out to investigate the cost and impact of Port and PICC for patients. The cost at different time of intravenous administration was calculated and compared. One-way sensitivity analysis was performed and tornado graph was drawn. RESULTS: Direct cost of Port at 0.5, 1, 1.5, and 2 years were7442, 8005, 8553, and 9131 CNY, and 4700, 9399, 14032, 18799 CNY for PICC respectively. Direct & indirect cost at 0.5, 1, 1.5, and 2 years were 9291, 11704, 14101, 16529 CNY for Port and 9697, 19393, 29023, 38787 CNY for PICC. Sensitivity analysis showed that productivity loss and device maintenance cost were the most in?uential factors to the result. CONCLUSION: Port had higher cost in short term and less in long term compared with PICC. Patients expected to get intravenous administration more than 0.5 year should use Port if both direct and indirect costs were included.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
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.
文摘目的探讨末端瓣膜耐高压注射型经外周静脉穿刺中心静脉置管(application of power peripherally inserted central catheter solo,Power PICC Solo)与经锁骨下中心静脉置管(central venous catheter,CVC)在造血干细胞移植患者中的应用。方法选取2021年9月—2023年6月厦门大学附属第一医院收治的100例造血干细胞移植患者。根据患者置管方法分为外周静脉穿刺中心静脉置管(peripherally inserted central catheter,PICC)组(n=58)和CVC组(n=42),PICC组采用Power PICC Solo,CVC组采用CVC。比较2组患者的置管成功情况、操作时间、导管置留时间、置管费用、置管后舒适度、患者液体流速、并发症发生率、患者满意度。结果PICC组置管成功率优于CVC组,差异有统计学意义(P<0.05)。PICC组操作时间短于CVC组,导管置留时间长于CVC组,置管费用高于CVC组,差异有统计学意义(P<0.05)。PICC组患者舒适度优于CVC组,差异有统计学意义(P<0.05)。在置管后第1、10、20、30天,PICC组患者液体流速均低于CVC组,且2组患者置管后第30天流速均低于置管后第1天,差异有统计学意义(P<0.05)。PICC组患者血栓性静脉炎发生率高于CVC组,导管感染发生率低于CVC组,差异有统计学意义(P<0.05),2组患者血气胸、导管异位、导管脱落等发生率比较,差异无统计学意义(P>0.05)。PICC组操作技术满意度评分为(17.24±2.17)分,高于CVC组的(14.07±2.68)分,差异有统计学意义(P<0.05)。结论与CVC比较,Power PICC Solo能够提高造血干细胞移植患者一次置管成功率,降低置管操作时间,延长导管置留时间,提高患者置管后舒适度,但置管费用较高,且血栓性静脉炎发生率高。
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.
文摘目的总结血液肿瘤患者PICC相关并发症预防的最佳证据,为临床实践提供参考。方法系统检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、医脉通、美国国立指南库、英国国家卫生与临床优化研究所网站、乔安娜布里格斯研究所(JBI)数据库、国际指南协作网、苏格兰校际指南网站、WHO网站、BMJ、Up To Date、Embase、PubMed、Web of Science、Cochrane Library关于血液科肿瘤患者PICC并发症预防的相关文献,检索时间为建库至2022年6月30日,对符合纳入排除标准的文献进行质量评价、证据分级及整合。结果最终纳入11篇文献,其中指南3篇、系统评价3篇、干预性研究2篇、专家共识3篇,总结出包括PICC评估与管理、置管前预防、置管中预防、置管后预防和健康教育5个方面的31条证据。结论本研究总结的血液肿瘤患者PICC相关并发症预防的最佳证据具有良好的科学性和系统性,可为提高患者治疗效果、减轻其经济负担提供循证依据,但应结合临床现况,针对性地运用最佳证据。
文摘目的:系统检索国内外经外周置入中心静脉导管(PICC)相关性血栓风险预测模型的研究并对其基本特征、建模过程、预测性能和验证方法等进行分析和评价。方法:在PubMed、EMbase、Web of Science、万方、维普和知网等数据库检索相关研究,由2名研究者独立进行文献筛选和文献资料提取,并根据PROBAST工具对纳入研究进行质量评价。结果:共纳入13个PICC相关性血栓风险预测模型,建模人群以肿瘤病人为主(n=7);11个模型报道了其预测性能,受试者工作特征(ROC)曲线下面积(AUC)值或C指数为0.64~0.89;5个模型进行了内部验证,4个模型进行了外部验证。质量评价结果为1个低偏倚风险和12个高偏倚风险。预测模型中最常见且赋值较高的预测因子包括化疗史、血栓史、糖尿病、肥胖或体质指数(BMI)≥25 kg/m2、导管尖端位置异位/非最佳位置及白细胞计数升高等。结论:现有研究表明,PICC相关性血栓风险预测模型预测准确度较高,但整体研究质量偏低,仍需从模型构建过程、模型验证和结果报告等方面进一步优化,以便为临床医务工作者提供可早期识别PICC相关性血栓高危人群的可靠的、科学的评估工具。
文摘OBJECTIVE: To calculate and compare the cost of Port and PICC's application in long-term intravenous administration, and to support the decision making of hospital manager. METHODS: Literature review and patient survey in 2 oncology centers in China were carried out to investigate the cost and impact of Port and PICC for patients. The cost at different time of intravenous administration was calculated and compared. One-way sensitivity analysis was performed and tornado graph was drawn. RESULTS: Direct cost of Port at 0.5, 1, 1.5, and 2 years were7442, 8005, 8553, and 9131 CNY, and 4700, 9399, 14032, 18799 CNY for PICC respectively. Direct & indirect cost at 0.5, 1, 1.5, and 2 years were 9291, 11704, 14101, 16529 CNY for Port and 9697, 19393, 29023, 38787 CNY for PICC. Sensitivity analysis showed that productivity loss and device maintenance cost were the most in?uential factors to the result. CONCLUSION: Port had higher cost in short term and less in long term compared with PICC. Patients expected to get intravenous administration more than 0.5 year should use Port if both direct and indirect costs were included.
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。
