Abstract:

Objective To compare the clinical effects of single-puncture and double-puncture subcutaneous tunneling techniques for PICC placement in cancer patients，and to provide references for nurses in selecting appropriate catheterization methods. Methods A continuous sampling method was adopted to select cancer patients who underwent PICC placement in the Department of Oncology at a tertiary general hospital in Nanning from June 2022 to December 2023. According to the actual catheterization technique received by patients，they were assigned to either the single-puncture or double-puncture subcutaneous tunneling group. After 1 ∶ 1 propensity score matching （PSM），the 2 groups were compared in terms of catheter-related complication rates，pain scores and total catheterization time. Results After propensity score matching，79 patients were included in each group. The results showed that the incidence of catheter-related thrombosis，pain scores，and total catheterization time in the one-needle subcutaneous tunneling group were significantly lower than those in the two-needle subcutaneous tunneling group，with statistically significant differences（P<0.05）. Conclusion The one-needle subcutaneous tunneling method can effectively reduce the incidence of catheter-related thrombosis and pain during catheterization in cancer patients，while also shortening the total catheterization time.

Key words: Subcutaneous Tunneling, Peripherally Inserted Central Catheter, Complications, Oncology Nursing

摘要：

目的 比较一针式与两针式皮下隧道法在肿瘤患者PICC置管中的应用效果，为护士合理选择置管方法提供参考。方法 采用定点连续抽样法，选取2022年6月—2023年12月在南宁市某三级甲等综合医院肿瘤内科接受PICC置管的肿瘤患者作为研究对象，根据患者实际接受的置管方式，将患者分为一针式皮下隧道组和两针式皮下隧道组。通过1 ∶ 1倾向性评分匹配后进行对比分析，比较两组导管相关并发症发生率、疼痛评分及置管总时间。结果 经倾向性评分匹配后，两组均纳入79例患者。结果显示，一针式皮下隧道组导管相关性血栓发生率、疼痛评分均低于两针式皮下隧道组，置管总时间少于两针式皮下隧道组，差异具有统计学意义（P<0.05）。结论 采用一针式皮下隧道法置管可有效降低肿瘤患者导管相关性血栓发生率和置管过程中的疼痛感，同时可缩短置管总时间。

关键词: 皮下隧道, 经外周穿刺中心静脉导管, 并发症, 肿瘤护理