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
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
目的对比经外周静脉穿刺置入中心静脉导管(Peripherally Inserted Central Catheter,PICC)带量采购前后的临床使用情况及患者治疗费用,为优化临床决策、完善医用耗材带量采购政策提供参考。方法通过关键知情人访谈收集PICC带量采购前后...目的对比经外周静脉穿刺置入中心静脉导管(Peripherally Inserted Central Catheter,PICC)带量采购前后的临床使用情况及患者治疗费用,为优化临床决策、完善医用耗材带量采购政策提供参考。方法通过关键知情人访谈收集PICC带量采购前后的临床使用情况,基于文献回顾、关键知情人访谈等构建PICC整体费用模型,采用Kruskal-Wallis检验对患者整体治疗费用进行分析。结果通过护士访谈,带量后的PICC实际平均留置时间相较于带量前平均留置时间缩短10.77%、穿刺时间增加14.21%、置管后导致的并发症或不良反应发生率相对带量前均有不同程度的上升;PICC带量采购前后患者的住院费用、卫材费差异均有统计学意义(P<0.05)。带量采购后的PICC单价和均次置管总费用明显下降,但均次并发症费用呈上升趋势,差异均有统计学意义(P<0.05)。结论带量采购后,PICC的质量及临床使用情况并不十分理想。建议各医疗主体加强对医用耗材带量采购前、中、后的质量评估体系建设和临床使用监测,系统分析患者治疗费用,逐步建立针对医用耗材带量采购的质量和整体费用评价标准,进一步完善医用耗材带量采购体系。展开更多
目的探讨新生儿经外周静脉置入中心静脉导管(PICC)并发胸腔积液的临床特点、病因及防治措施,为临床诊治PICC相关新生儿胸腔积液提供依据。方法回顾2例新生儿PICC置管并发胸腔积液的临床资料,并以关键词“经外周静脉置入中心静脉导管”...目的探讨新生儿经外周静脉置入中心静脉导管(PICC)并发胸腔积液的临床特点、病因及防治措施,为临床诊治PICC相关新生儿胸腔积液提供依据。方法回顾2例新生儿PICC置管并发胸腔积液的临床资料,并以关键词“经外周静脉置入中心静脉导管”“胸腔积液”“PICC并发症”“peripherally inserted central catheter”“neonatal”“pleural effusion”“PICC complications”搜索中国知网(CNKI)、中华医学期刊全文数据库、PubMed、Web of science、Embase等数据库,检索2010年1月至2023年6月收录的文献。总结新生儿PICC相关胸腔积液的临床特点、治疗及预后。结果2例患儿均在PICC置管情况下突发呼吸困难,影像学检查及胸腔穿刺证实为PICC导管渗出性胸腔积液发生,通过立即拔除PICC导管以及行胸腔穿刺,胸腔积液吸收,经积极治疗后均治愈出院,预后良好。纳入文献16篇,总计53例患儿进行分析。53例患儿均为早产儿,除1例出生体重不详外,其余52例患儿均为低出生体重儿,其中极低出生体重儿44例,比例约80.2%,超低出生体重儿占比约11.3%。除1例未具体说明置管穿刺点外,其余52例患儿中,选择经上肢静脉置比例94.2%,下肢为3.8%。除8例未具体说明导管尖端位置外,其余病例中80%发生异位,以远心端方向异位居多,占比77.8%。结论新生儿PICC可并发胸腔积液,临床需引起重视并及时防范,正确处理,一般预后良好。展开更多
目的本研究旨在探讨融入胸部CT测量法在预测肺癌患者耐高压型经外周置入中心静脉导管(peripherally inserted central catheter,PICC)最佳尖端位置中的应用效果。方法选取来自2023年8—12月在陕西省某三甲医院胸外科行PICC置管的205例...目的本研究旨在探讨融入胸部CT测量法在预测肺癌患者耐高压型经外周置入中心静脉导管(peripherally inserted central catheter,PICC)最佳尖端位置中的应用效果。方法选取来自2023年8—12月在陕西省某三甲医院胸外科行PICC置管的205例肺癌患者。采用计算机随机法将患者随机分为对照组(传统的体表横“L”测量法)102例和观察组(融入胸部CT测量法)103例。主要评价指标为PICC导管最佳尖端位置的准确率,次要评价指标为置管后30 d内并发症的发生率。结果2组PICC最佳尖端位置的准确率分别为86.41%和30.39%,观察组高于对照组(OR=14.560,95%CI:7.202~29.437,P<0.001)。调整性别、年龄和BMI的影响后,2组间最佳尖端位置的准确率差异仍具有统计学意义(OR=16.383,95%CI:7.824~34.308,P<0.001)。观察组30 d内导管滑脱的风险低于对照组(1.94%vs 11.76%,OR=0.154,95%CI:0.033~0.718,P=0.017),2组间机械性静脉炎的发生率差异无统计学意义(P>0.05)。结论融入胸部CT测量法可提高PICC最佳尖端位置准确率,降低导管滑脱的发生率。本研究作为一项护理新技术,研究结果可推广到肺癌等其他需要常规行胸部CT检查的患者领域,在不额外增加辐射和费用的前提下,可提高PICC测量的准确性。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.
文摘目的对比经外周静脉穿刺置入中心静脉导管(Peripherally Inserted Central Catheter,PICC)带量采购前后的临床使用情况及患者治疗费用,为优化临床决策、完善医用耗材带量采购政策提供参考。方法通过关键知情人访谈收集PICC带量采购前后的临床使用情况,基于文献回顾、关键知情人访谈等构建PICC整体费用模型,采用Kruskal-Wallis检验对患者整体治疗费用进行分析。结果通过护士访谈,带量后的PICC实际平均留置时间相较于带量前平均留置时间缩短10.77%、穿刺时间增加14.21%、置管后导致的并发症或不良反应发生率相对带量前均有不同程度的上升;PICC带量采购前后患者的住院费用、卫材费差异均有统计学意义(P<0.05)。带量采购后的PICC单价和均次置管总费用明显下降,但均次并发症费用呈上升趋势,差异均有统计学意义(P<0.05)。结论带量采购后,PICC的质量及临床使用情况并不十分理想。建议各医疗主体加强对医用耗材带量采购前、中、后的质量评估体系建设和临床使用监测,系统分析患者治疗费用,逐步建立针对医用耗材带量采购的质量和整体费用评价标准,进一步完善医用耗材带量采购体系。
文摘目的探讨新生儿经外周静脉置入中心静脉导管(PICC)并发胸腔积液的临床特点、病因及防治措施,为临床诊治PICC相关新生儿胸腔积液提供依据。方法回顾2例新生儿PICC置管并发胸腔积液的临床资料,并以关键词“经外周静脉置入中心静脉导管”“胸腔积液”“PICC并发症”“peripherally inserted central catheter”“neonatal”“pleural effusion”“PICC complications”搜索中国知网(CNKI)、中华医学期刊全文数据库、PubMed、Web of science、Embase等数据库,检索2010年1月至2023年6月收录的文献。总结新生儿PICC相关胸腔积液的临床特点、治疗及预后。结果2例患儿均在PICC置管情况下突发呼吸困难,影像学检查及胸腔穿刺证实为PICC导管渗出性胸腔积液发生,通过立即拔除PICC导管以及行胸腔穿刺,胸腔积液吸收,经积极治疗后均治愈出院,预后良好。纳入文献16篇,总计53例患儿进行分析。53例患儿均为早产儿,除1例出生体重不详外,其余52例患儿均为低出生体重儿,其中极低出生体重儿44例,比例约80.2%,超低出生体重儿占比约11.3%。除1例未具体说明置管穿刺点外,其余52例患儿中,选择经上肢静脉置比例94.2%,下肢为3.8%。除8例未具体说明导管尖端位置外,其余病例中80%发生异位,以远心端方向异位居多,占比77.8%。结论新生儿PICC可并发胸腔积液,临床需引起重视并及时防范,正确处理,一般预后良好。
