乳腺癌患者B超引导PICC置管与常规置管优势分析(1)
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[摘要] 目的：比较B超引导PICC置管与常规置管的临床效果，选择更佳的方法以减轻患者身体和心理负担。方法：选择2009年8月～2011年2月于我科诊断为乳腺癌，术前行PICC置管进行新辅助化疗的98例患者，将其分为实验组和对照组，实验组48例，行B超引导PICC置管；对照组50例，行常规肉眼下穿刺置管，比较两组穿刺指标和穿刺部位并发症发生情况。结果：实验组发生局部血肿、感染及总感染的人数均显著低于对照组(χ2=7.889，P=0.005；P=0.027；χ2=10.152，P=0.001)，而实验组穿刺操作时间、置管一次成功率和穿刺次数均优于对照组，差异均有统计学意义(t=2.679，P=0.010；χ2=16.638，P=0；χ2=10.767，P=0.001)。结论：B超引导PICC置管操作方便，安全性高，较常规置管优势明显。
[关键词] 乳腺癌；PICC置管；常规置管；优势分析
[中图分类号] R473 [文献标识码] A [文章编号] 1673-7210(2011)11(b)-115-03
The advantage analysis between ultrasound-guided PICC and traditional catheterization for patients with breast cancer
GUO Hongxia
Department of Oncology, the General Hospital of PLA, Beijing 100853, China
[Abstract] Objective: To compare the clinical effect of ultrasound-guided PICC and traditional catheterization, in order to choose a better method to relieve the physical and mental burden of patients. Methods: 98 patients who had undergone neoadjuvant chemotherapy by PICC before breast cancer surgery in our hospital from August 2009 to February 2011 were divided into two groups. Experimental group had 48 cases and was taken ultrasound-guided PICC; control group had 50 cases and was taken traditional catheterization. The puncture index and complications were compared between the two groups. Results: The local hematoma, local infection and total number of infection in experimental group were significantly lower than those in control group (χ2=7.889, P=0.005; P=0.027; χ2=10.152, P=0.001), whereas the operating time, success rate of catheter and frequency of puncture were obviously superior to those in control group (t=2.679, P=0.010; χ2=16.638, P=0; χ2=10.767, P=0.001). Conclusion: Ultrasound-guided PICC has convenient operation and high safety, which is an obvious advantage compared with conventional method.
[Key words] Breast cancer; Ultrasound-guided PICC; Traditional catheterization; Advantage analysis
近些年来，术前4～8个周期新辅助化疗已经应用于乳腺癌的治疗中，但化疗期间反复的经外周静脉穿刺给药，容易引起穿刺静脉的相应并发症。经外周静脉穿刺中心静脉导管置管(peripherally inserted central catheter，PICC)技术是由外周静脉，如肘部贵要静脉、肘正中静脉等穿刺，使硅胶导管进入上腔静脉或锁骨下静脉[1]。由于PICC术操作简便安全，术后并发症少，且可以将化疗药物直接输入大的中心静脉，减少患者反复静脉穿刺的痛苦 ......
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