Urethral catheterization is an important skill to develop as consultations for“difficult catheterization”are common in practice.Developing a broad approach to difficult urethral catheterization is crucial to improve...Urethral catheterization is an important skill to develop as consultations for“difficult catheterization”are common in practice.Developing a broad approach to difficult urethral catheterization is crucial to improve trainee success rates.Strategies and techniques to improve catheterization success are often passed down and shared between trainees without formal documentation or dissemination of techniques.Herein,we present a framework for difficult urethral catheterization based on clinical history and patient examination,while also providing additional techniques and troubleshooting to overcome common challenges with urethral catheterization in adult and pediatric patients.展开更多
BACKGROUND Urologists are commonly consulted regarding difficult and traumatic urethral catheterizations.Complications surrounding Foley catheterizations represent a significant burden to the healthcare system.AIM To ...BACKGROUND Urologists are commonly consulted regarding difficult and traumatic urethral catheterizations.Complications surrounding Foley catheterizations represent a significant burden to the healthcare system.AIM To assess the demographic and patient characteristics surrounding urological consultation for difficult and traumatic Foley catheterizations at our institution across multiple hospitals.METHODS This is a single-institution,multi-hospital,263 patient,retrospective chart review from Jan 2020–December 2023.RESULTS The majority of consultations(80.2%)did not require heroic measures by the urology service.A Foley catheter placement was determined not difficult in the majority 191(72.6%)of patients.Sub-group analysis of“difficult by urology”vs“not difficult by urology”,showed a significant difference between those with zero attempts,one attempt,and greater than one attempts(P=0.004).Those patients specifically with greater than one attempts were more likely to be seen as a difficult insertion by urology assessment(60.6%)compared to not difficult(38.6%).Likewise,those patients with a history of difficult urethral catheter(DUC)/traumatic urethral catheterization(TUC)(25.8%)were more likely to be difficult compared to those without a history of DUC/TUC(14.2%)(P=0.038).CONCLUSION The study found that majority of consultations received did not require heroic measures by the urology service to place a catheter.Patients who had a history of DUC/TUC and those who had greater than one catheter attempts were statistically more likely to be a DUC based on urology assessment.At our institution we hope to propose a protocol in which nursing staff and non-urologic clinicians will utilize a troubleshooting checklist and an algorithm when difficult or traumatic urethral catheters are encountered in order to improve patient care and decrease healthcare costs.For example,this protocol would ideally address complications of multiple catheter attempts such as urethral trauma,development of urethral strictures,and infection risk.Additionally,future trainings and availability of additional resources will be provided and assessed with a goal of reducing healthcare cost surrounding these complications.展开更多
Background:The choice of a basket or a balloon catheter during endoscopic retrograde cholangiopancreatography(ERCP)for the clearance of pancreatic duct stones in patients with chronic pancreatitis(CP)remains controver...Background:The choice of a basket or a balloon catheter during endoscopic retrograde cholangiopancreatography(ERCP)for the clearance of pancreatic duct stones in patients with chronic pancreatitis(CP)remains controversial.This study compared the efficacy and safety of these two devices for pancreatic duct stone extractions.Methods:We compared the efficacy and safety of basket and balloon catheters for pancreatic stone extractions.We enrolled CP patients who underwent ERCP for the first time at Changhai Hospital,Naval Medical University between February 2012 and December 2021.After propensity score matching(1:1),101 patients were included in each group.The primary outcome was the rate of pancreatic stone clearance.Secondary outcomes included the rate of adverse events during hospitalization,long-term pain relief,and quality of life after one year follow-up period.Results:The rate of complete clearance was comparable between the two groups(86.1%vs.84.2%,P=0.692).In patients with stones≥2 cm before extracorporeal shock wave lithotripsy(ESWL),the rate of complete clearance was significantly higher in the balloon catheter group when compared to the basket catheter group[100%(19/19)vs.70.0%(14/20),P=0.031].In the multivariate logistic analysis,ESWL prior to stone extraction was the only independent predictor of complete clearance[with ESWL 58.4%(264/452)vs.without ESWL 41.6%(188/452),odds ratio=2.3,95%confidence interval:1.2–4.3;P=0.013].No significant differences between groups were found regarding the rates of adverse events during hospitalization,quality of life,and pain relief after one year of follow-up.Conclusions:Basket and balloon catheters showed similar efficacy and safety for pancreatic stone extractions.However,the balloon catheter was superior to the basket catheter if the pancreatic stone size was≥2 cm before ESWL.展开更多
BACKGROUND Peripherally inserted central catheters(PICCs)are crucial for patients requiring long-term intravenous therapy,especially within digestive surgery under bundled care protocols.AIM To evaluate and compare th...BACKGROUND Peripherally inserted central catheters(PICCs)are crucial for patients requiring long-term intravenous therapy,especially within digestive surgery under bundled care protocols.AIM To evaluate and compare the efficacy,safety,and patient-reported outcomes of single-lumen vs double-lumen PICCs among patients undergoing digestive surgery within a structured bundled care framework.METHODS This retrospective cohort study analyzed data from 249 patients who underwent digestive surgery and utilized either single-lumen(n=117)or double-lumen(n=132)PICCs between January 2021 and June 2024.Clinical outcomes,patient satisfaction,catheterization duration,and complication rates were compared using statistical analysis via SPSS(version 29.0).The bundled care protocol was consistently applied,focusing on standardized procedures,staff training,and patient support.RESULTS Single-lumen PICCs were associated with a significantly lower thrombosis rate(0.85%)than double-lumen PICCs(6.82%,P=0.039).The single-lumen group experienced shorter catheterization durations(12.5±3.14 days vs 13.6±4.50 days,P=0.025)and higher successful infusion rates(92.7%±5.32%vs 90.4%±6.60%,P=0.003).This group also reported higher comfort scores(8.40±1.20 vs 7.90±1.50,P=0.004)and lower pain levels(2.90±0.70 vs 3.20±0.80,P=0.002).Aside from thrombosis,complication rates showed no significant difference between the groups.CONCLUSION Within bundled care context,single-lumen PICCs demonstrated advantages in reducing thrombosis risk,procedural efficiency,patient comfort,and satisfaction compared with double-lumen PICCs.The findings underscore the importance of considering patient-specific needs and clinical scenarios in catheter choice.展开更多
Urinary catheters are essential medical devices widely used for patients requiring urinary drainage,bladder irrigation,or precise urine output monitoring.Transurethral catheters with anchoring balloons are particularl...Urinary catheters are essential medical devices widely used for patients requiring urinary drainage,bladder irrigation,or precise urine output monitoring.Transurethral catheters with anchoring balloons are particularly prevalent among hospitalized patients,facilitating continuous urinary drainage.展开更多
Objective:Patients after radical gastrectomy often require medium-to long-term intravenous therapy.However,traditional central venous catheters(CVCs)have issues such as high infection risk and poor comfort.This study ...Objective:Patients after radical gastrectomy often require medium-to long-term intravenous therapy.However,traditional central venous catheters(CVCs)have issues such as high infection risk and poor comfort.This study aims to deeply explore the clinical application value of peripherally inserted central catheters(PICCs)after radical gastrectomy,providing a scientific basis for optimizing intravenous access selection.Methods:Fifty patients requiring catheterization after radical gastrectomy at the Friendship Hospital of Ili Kazak Autonomous Prefecture from December 2022 to May 2024 were selected.Catheterization site selection was based on patients’preferences,dividing them into two groups:the experimental group receiving PICCs and the control group receiving CVCs,with 25 patients in each group.Multi-dimensional comparative analysis was conducted,including catheterization operation time,catheter indwelling time,success rates of first and second catheterizations,and complication rates.Statistical methods such as t-tests and chi-square tests were used for in-depth analysis.Results:Compared to the control group,the experimental group had longer catheterization operations and catheter indwelling times,and a higher success rate of first catheterization(P<0.05).The incidence of catheterization complications in the experimental group was 12.00%,lower than the 40.00%in the control group(P<0.05).Conclusion:Although PICC catheterization after radical gastrectomy has relatively longer catheterization operation and indwelling times,it has a high success rate of first catheterization and a low complication rate,demonstrating high clinical application value and worth promoting in clinical practice.展开更多
BACKGROUND Long-term chemotherapy for patients with gastric cancer(GC),facilitated by peripherally inserted central catheter(PICC)catheterization,reduces vascular damage and enhances drug delivery efficiency but carri...BACKGROUND Long-term chemotherapy for patients with gastric cancer(GC),facilitated by peripherally inserted central catheter(PICC)catheterization,reduces vascular damage and enhances drug delivery efficiency but carries risks of catheter-related complications.A combination of group psychological nursing and physical mo-vement care significantly mitigates the risk of venous thrombosis and improves psychological well-being,and enhances motor function,underscoring its clinical importance.AIM To assess group psychological and physical movement nursing in preventing venous thrombosis in patients with PICC GC.METHODS Sixty-five GC patients with PICC,admitted from January 2022 to January 2023,were randomly divided into two groups using the lottery method:A control group(n=35,routine nursing)and an observation group(n=30,routine nursing plus psychological nursing and physical movement nursing).Both groups re-ceived continuous care for 2 weeks.Pre-nursing and post-nursing data on psycho-logical state,physical function,chemotherapy-related thrombosis incidence,and cancer-related fatigue were analyzed using SPSS 26.0 and GraphPad Prism 8.0.RESULTS After nursing,both groups showed reduced Hamilton Anxiety Scale scores and increased General Perceived Self-Efficacy Scale scores,with the observation group performing better(P<0.05).The Functional Comprehensive Assessment score for the observation group after nursing was(65.42±2.35)points,lower than the control group’s(62.19±4.33)points(P<0.05).Although no significant difference was observed in the incidence of venous thrombosis between the two groups(χ2=0.815,P=0.367),the observation group had lower incidence.Both groups showed decreased Revised Piper Fatigue Scale scores,with the observation group scoring lower(P<0.05).CONCLUSION Group psychological and physical movement nursing for patients with PICC reduces venous thrombosis risk,improves psychological well-being,cancer-related fatigue,and physical function,making it highly promotable.展开更多
Persistent left superior vena cava(PLSVC)is a congenital anomaly where the left-sided vena cava,which usually regresses during fetal development,persists.Double superior vena cava resulting from a PLSVC is indeed a ra...Persistent left superior vena cava(PLSVC)is a congenital anomaly where the left-sided vena cava,which usually regresses during fetal development,persists.Double superior vena cava resulting from a PLSVC is indeed a rare phenomenon.In the general population,the incidence of this condition is reported to be between 0.3%and 2.1%.[1]While this anatomical variation is often asymptomatic and discovered incidentally,it becomes relevant in certain clinical scenarios.Indeed,the presence of a PLSVC and double superior vena cava can pose challenges as incorrect positioning and result in failure.展开更多
BACKGROUND Endoscopic retrograde cholangiopancreatography is a challenging procedure involving bile duct cannulation.Despite the development of several cannulation devices,none have effectively facilitated the procedu...BACKGROUND Endoscopic retrograde cholangiopancreatography is a challenging procedure involving bile duct cannulation.Despite the development of several cannulation devices,none have effectively facilitated the procedure.AIM To evaluate the efficacy of a recently developed catheter for bile duct cannulation.METHODS We retrospectively examined 342 patients who underwent initial cholangiopan-creatography.We compared the success rate of bile duct cannulation and the incidence of complications between the groups using existing and novel catheters.RESULTS The overall success rates of bile duct cannulation were 98.3%and 99.1%in the existing and novel catheter groups,respectively(P=0.47).The bile duct cannulation rate using the standard technique was 73.0%and 82.1%in the existing and novel catheter groups,respectively(P=0.042).Furthermore,when catheterization was performed by expert physicians,the bile duct cannulation rate was significantly higher in the novel catheter group(81.3%)than in the existing catheter group(65.2%)(P=0.017).The incidence of difficult cannulation was also significantly lower in the novel catheter group(17.4%)than in the existing catheter group(33.0%)(P=0.019).CONCLUSION The novel catheter improved the bile duct cannulation rate using the standard technique and reduced the frequency of difficult cannulation cases,valuable tool in endoscopic retrograde cholangiopancreatography procedures performed by experts.展开更多
Pulmonary embolism(PE)ranks as the third leading cause of cardiovascularrelated deaths in Western nations.Patients classified as high-risk(HR)-those exhibiting hemodynamic instability-require immediate interventions t...Pulmonary embolism(PE)ranks as the third leading cause of cardiovascularrelated deaths in Western nations.Patients classified as high-risk(HR)-those exhibiting hemodynamic instability-require immediate interventions to restore blood flow.While intermediate–HR(IHR)individuals remain hemodynamically stable,they face a significant chance of clinical decline and thus need close and continuous observation.Effective risk assessment,mortality prediction,and therapeutic decision-making in these patients rely on a combination of clinical evaluation and imaging studies.Catheter-directed therapy(CDT)has emerged as a promising option,offering the ability to alleviate clot burden and reduce strain on the right ventricle,all while posing a lower risk of major bleeding compared to systemic thrombolysis.The growing adoption of CDT reflects its increasing relevance in PE treatment,especially when managed by specialized PE response teams that ensure individualized,multidisciplinary care.As clinical practices evolve,further studies and robust clinical trials are necessary to clearly define CDT’s role in lowering the risks of complications and death among IHR PE patients.This article explores the current understanding and future direction of managing PE,focusing in the role of catheter-based interventions.展开更多
Atrial fibrillation(Afib)is a common arrhythmia with significant public health implications,affecting millions of individuals worldwide.Catheter ablation(CA)is an established treatment for drug-resistant Afib,yet recu...Atrial fibrillation(Afib)is a common arrhythmia with significant public health implications,affecting millions of individuals worldwide.Catheter ablation(CA)is an established treatment for drug-resistant Afib,yet recurrence remains a major concern,impacting quality of life in a significant portion of patients.Inflammation plays a critical role in the recurrence of Afib after ablation,with systemic inflammatory markers such as C-reactive protein being linked to higher recurrence rates.In this editorial,we discuss the study by Wang et al,published in the latest issue,which investigates the predictive role of the systemic immune inflammation index(SII)in Afib recurrence following radiofrequency CA.Elevated pre-ablation SII levels are identified as an independent predictor of recurrence,significantly enhancing the predictive power of the APPLE score.Integration of SII improved the APPLE score’s predictive performance,as shown by enhanced area under the curve,net reclassification improvement,and integrated discrimination improvement.This combined model highlights the importance of both structural and inflammatory factors in Afib recurrence,offering a more personalized approach to patient management.Additionally,the affordability and accessibility of SII enhance its practicality in clinical workflows.The study by Wang et al underscores the potential of integrating SII with existing scoring systems to refine risk stratification and optimize treatment strategies.Future research should validate these findings across diverse populations,explore limitations such as the potential influence of comorbidities on SII reliability,and investigate additional biomarkers to enhance predictive accuracy.展开更多
The recurrence of atrial fibrillation(AF)in patients after successful radiofrequency catheter ablation(RFCA)appears to be an unresolved clinical issue and needs to be clearly elucidated.There are many factors associat...The recurrence of atrial fibrillation(AF)in patients after successful radiofrequency catheter ablation(RFCA)appears to be an unresolved clinical issue and needs to be clearly elucidated.There are many factors associated with AF recurrence,such as duration of AF,male sex,concomitant heart failure,hemodynamic parameters,chronic obstructive pulmonary disease,hypertension,obstructive sleep apnea,hyperthyroidism,smoking and obesity.However,the inflammatory changes are strongly associated with electrical and structural cardiac remodeling,cardiac damage,myocardial fibrotic changes,microvascular dysfunction and altered reparative response.In this context,biomarkers reflecting the different stages of AF pathogenesis deserve thorough investigation.The authors of the retrospective study revealed that one-year recurrence rate of non-valvular AF in the high systemic immune inflammation(SII)index group was significantly increased compared to that of the low SII index group and provided additional predictive value to the APPLE.Furthermore,the authors suggest that this biomarker may help physicians to optimize the selection of AF patients and to develop a personalized treatment approach.In conclusion,the SII index may serve as a valuable indicator of recurrent AF in patients after RFCA and may be a biomarker with plausible predictive value for poor clinical outcomes.展开更多
BACKGROUND Ultrasound-guided peripherally inserted central catheter(PICC)placement is vital for cancer therapy,but lidocaine infiltration faces limitations like puncture pain and vasospasm.AIM To assess the clinical e...BACKGROUND Ultrasound-guided peripherally inserted central catheter(PICC)placement is vital for cancer therapy,but lidocaine infiltration faces limitations like puncture pain and vasospasm.AIM To assess the clinical efficacy of a no-pain intervention-combining compound lidocaine cream with warm compress-in reducing pain during ultrasound-guided PICC placement in cancer patients.METHODS A retrospective cohort study analyzed 88 cancer patients undergoing PICC placement(Shanghai Fourth People’s Hospital,2024).Patients were divided into control(lidocaine infiltration,n=44)and intervention(cream+warm compress,n=44)groups.Primary outcomes:Pain scores(numerical rating scale),procedural time,complications;secondary outcome:Satisfaction.RESULTS The intervention group showed significantly lower pain scores(1.2±0.4 vs 3.8±1.2,P=0.012)with comparable first-attempt success(95.5%vs 90.9%)and safety(P=0.672).Thermal activation of transient receptor potential vanilloid 1 channel enhanced drug penetration,achieving anesthesia within 8-10 minutes.Patient satisfaction reached 97.7%.CONCLUSION The combination of compound lidocaine cream with warm compress significantly alleviates procedural pain and enhances patient satisfaction during ultrasound-guided PICC placement in cancer patients,supporting its clinical application.展开更多
Objective:To observe the intervention effect of clinical nursing pathway on patients receiving intravenous therapy via peripheral mid-long catheters.Methods:Ninety patients receiving intravenous therapy via mid-long c...Objective:To observe the intervention effect of clinical nursing pathway on patients receiving intravenous therapy via peripheral mid-long catheters.Methods:Ninety patients receiving intravenous therapy via mid-long catheters in the hospital from March 2024 to March 2025 were selected and randomly divided into a control group and an observation group,with 45 patients in each group.The control group received routine nursing intervention,while the observation group received clinical nursing pathway intervention.The nursing risk events,catheter indwelling time,and nursing satisfaction were evaluated in both groups.Results:The observation group had a shorter catheter indwelling time,fewer risk events during intravenous therapy(total incidence rate of 2.22%),and higher nursing satisfaction.Additionally,negative emotional feedback was reduced,and the SAS score(31.02±1.12)was lower in the observation group compared to the control group.There were significant differences between the two groups in all indicators(P<0.05).Conclusion:Applying the clinical nursing pathway during intravenous therapy via peripheral mid-long catheters can help ensure infusion safety,improve unstable emotional states,and promote high-quality service standards.展开更多
Objective:To assess the effectiveness of a visual double-lumen bronchial catheter in teaching lung isolation skills to anesthesia resident trainees.Methods:Between September 2023 and September 2024,20 anesthesiology r...Objective:To assess the effectiveness of a visual double-lumen bronchial catheter in teaching lung isolation skills to anesthesia resident trainees.Methods:Between September 2023 and September 2024,20 anesthesiology residents from Jiangsu Cancer Hospital were randomly divided into two groups:the visual double-lumen group(n=10)and the conventional double-lumen group(n=10).Randomization was achieved using a random number table.The study assessed several outcomes,including total intubation time,positioning time,one-time intubation success rate,intraoperative catheter displacement rate,surgeon satisfaction scores,and the incidence of postoperative complications(pharyngeal pain,hoarseness,and dry cough)within 24 hours.Results:The visual double-lumen group demonstrated superior results compared to the conventional double-lumen group in the following measures:total intubation time(70.2±11.8 s vs 224.9±35.6 s),positioning time(30.1±5.7s vs 176.6±26.4 s),one-time intubation success rate(85%vs 45%),intraoperative catheter displacement rate(10%vs 40%),surgeon’s intubation satisfaction score(8.10±1.07 vs 6.90±1.41),satisfaction score for pulmonary isolation(8.35±1.04 vs 6.55±1.36),and airway management satisfaction score(8.40±1.3 vs 6.70±1.34).Additionally,the incidence of postoperative pharyngeal pain(15%vs 45%),hoarseness(10%vs 40%),and dry cough(5%vs 35%)was significantly lower in the visual double-lumen group(all P<0.05).Conclusion:The visual double-lumen bronchial catheter significantly enhances the training of anesthesia residents in lung isolation by reducing intubation and positioning times,improving intubation success rate,increasing surgeon satisfaction,and reducing intubation-related complications.This method offers a more effective teaching approach compared to conventional techniques.展开更多
Objective:To investigate the preventive effect of targeted nursing interventions on deep vein thrombosis in patients with hemodialysis catheter indwelling.Methods:A prospective study was conducted involving patients w...Objective:To investigate the preventive effect of targeted nursing interventions on deep vein thrombosis in patients with hemodialysis catheter indwelling.Methods:A prospective study was conducted involving patients who underwent hemodialysis catheter indwelling and were admitted between August 2023 and August 2025,totaling 108 cases.These patients were randomly divided into two groups using a random number table method,with 54 cases in each group.The control group received routine nursing interventions,while the observation group received targeted nursing interventions.The incidence of deep vein thrombosis and hemodynamic indicators were compared between the two groups.Results:The incidence of deep vein thrombosis in the observation group was lower than that in the control group(p<0.05).After two weeks of nursing,the hemodynamic indicators in the observation group were higher than those in the control group(p<0.05).Conclusion:Targeted nursing interventions can effectively prevent deep vein thrombosis and improve hemodynamics in patients with hemodialysis catheter indwelling,making them worthy of clinical promotion.展开更多
BACKGROUND Peripherally inserted central catheters(PICCs)are widely used for administering chemotherapy to breast cancer patients due to their long-term indwelling capability,versatility in drug administration,and fle...BACKGROUND Peripherally inserted central catheters(PICCs)are widely used for administering chemotherapy to breast cancer patients due to their long-term indwelling capability,versatility in drug administration,and flexibility.PICCs infection are a relatively common occurrence,yet there were no reported instances that it can metastasise to the lumbar spine.CASE SUMMARY This case report describes a breast cancer patient who developed a methicillinresistant Staphylococcus aureus lumbar vertebral infection secondary to a PICCrelated infection during chemotherapy.Following PICC removal,bacterial culture confirmed the presence of highly virulent methicillin-resistant Staphylococcus aureus.The patient presented with fever and severe lumbar pain.Lumbar magnetic resonance imaging revealed paraspinal muscle edema from L1 to L3 with abnormal signal intensity in the affected regions,suggestive of vertebral osteomyelitis.Prompt initiation of appropriate antibiotic therapy based on the culture results led to significant improvement in the patient’s lumbar pain.CONCLUSION This case highlights the importance of vigilant infection prevention and control measures to minimize the risk of PICC-related complications,such as bloodstream infections and subsequent metastatic infections.展开更多
Background Atrial fibrillation(AF)and hypertension are closely related,with hypertension being a significant risk factor for the development of AF.The aim of this study was to investigate the gender differences in the...Background Atrial fibrillation(AF)and hypertension are closely related,with hypertension being a significant risk factor for the development of AF.The aim of this study was to investigate the gender differences in the effects of radiofrequency catheter ablation(RFCA)on blood pressure regulation in patients with paroxysmal atrial fibrilla-tion(PAF)and primary hypertension.Methods This prospective cohort study included 65 patients(44 males,21 females)with PAF and primary hypertension who underwent RFCA.Blood pressure was measured preoperatively and at 3 months postoperatively using 24-hour ambulatory blood pressure monitoring.Changes in blood pressure parameters were compared between male and female patients.Results Significant gender differences were ob-served in 24-hour mean systolic blood pressure(24h SBP)and daytime mean systolic blood pressure(dSBP).In male patients,24h SBP decreased by 5.16 mmHg,and dSBP decreased by 4.30 mmHg,while female patients showed minimal changes,with a decrease of 1.44 mmHg in 24h SBP and 0.39 mmHg in dSBP.These changes were significantly different between genders(P<0.001 for 24h SBP and P=0.005 for dSBP).No significant differences were found between males and females in other blood pressure parameters(P>0.05).Conclusions RFCA signifi-cantly improved blood pressure control in male patients with PAF and primary hypertension,with more pronounced reductions in 24h SBP and dSBP compared to female patients.These findings suggested that gender may influence the effectiveness of RFCA in managing blood pressure in this population,underscoring the importance of consider-ing gender when planning treatment strategies.展开更多
Objective:To explore the evidence-based nursing optimization strategy for catheter tip positioning during peripherally inserted central catheter(PICC)insertion in patients with persistent left superior vena cava(PLSVC...Objective:To explore the evidence-based nursing optimization strategy for catheter tip positioning during peripherally inserted central catheter(PICC)insertion in patients with persistent left superior vena cava(PLSVC).Methods:For one ovarian cancer patient with PICC malposition in the coronary sinus(CS)due to PLSVC,multimodal imaging techniques were integrated to accurately locate the catheter tip.The catheter position was adjusted based on evidence(withdrawing 5 cm),and a standardized nursing process was established,including personalized health education,catheter fixation and displacement monitoring,complication monitoring,establishment of a specialized disease information archive system,and formulation of a follow-up plan.Results:The catheter tip was successfully withdrawn from the coronary sinus(at the T8 level)to the middle and lower part of the PLSVC(at the T6 vertebral level),and the catheter functioned normally after adjustment.No complications such as arrhythmia or thrombosis occurred during the 332-day chemotherapy period.Conclusion:The PICC tip in PLSVC patients should be positioned in the middle and lower part of the PLSVC(at the T5–T7 vertebral level).This new standard can effectively avoid CS-related complications.The integration of multi-modal imaging techniques and evidence-based nursing management are key to ensuring safe infusion.展开更多
BACKGROUND Peripherally inserted central catheter(PICC)is the preferred intravenous route for chemotherapy in patients with cancer,but its complications,especially deep vein thrombosis(DVT),are becoming increasingly p...BACKGROUND Peripherally inserted central catheter(PICC)is the preferred intravenous route for chemotherapy in patients with cancer,but its complications,especially deep vein thrombosis(DVT),are becoming increasingly prevalent.Medical staff proficient in intubation and maintenance techniques can reduce complications.The multivariate integration teaching model applies the integration of“teaching learning application”to medical training,which helps shift the prevention of complications from“passive management of complications”to“active construction of risk immunity”,thereby ensuring foundational competency for PICC in patients with cancer.AIM To investigate the efficacy of the multivariate integration teaching model in patients with gastric cancer and concurrent DVT after PICC intubation and analyze its effect on patients’quality of life index(QLI)and satisfaction.METHODS A retrospective analysis of medical records of 100 patients with gastric cancer and PICC treated at Zhejiang Provincial People’s Hospital from May 2019 to November 2020 was conducted.According to the different treatment methods and teaching modes received by medical staff,they were divided into a control group and an experimental group,with 50 cases in each group.The routine clinical teaching model and the multivariate integration teaching model were administered to the medical staff for the control group and the experimental group,respectively,to compare the incidence rates of DVT and other adverse reactions,QLI scores,Karnofsky Performance Scale scores,Mental Status Scale in Non-Psychiatric Settings scores,patient satisfaction,medical staff’s test marks,and satisfaction evaluation of the teaching model.RESULTS Compared with the control group,the experimental group exhibited significantly lower incidence rates of DVT and other adverse reactions and MSSNS scores but significantly higher QLI scores,KPS scores,patient satisfaction,medical staff’s test marks,and their satisfaction evaluations of the teaching model(P<0.05).CONCLUSION In a single-center practice,performing the multivariate integration teaching model for medical staff may effectively improve the patients’QLI and satisfaction and may have certain application value in preventing DVT in patients with gastric cancer and PICC.展开更多
文摘Urethral catheterization is an important skill to develop as consultations for“difficult catheterization”are common in practice.Developing a broad approach to difficult urethral catheterization is crucial to improve trainee success rates.Strategies and techniques to improve catheterization success are often passed down and shared between trainees without formal documentation or dissemination of techniques.Herein,we present a framework for difficult urethral catheterization based on clinical history and patient examination,while also providing additional techniques and troubleshooting to overcome common challenges with urethral catheterization in adult and pediatric patients.
文摘BACKGROUND Urologists are commonly consulted regarding difficult and traumatic urethral catheterizations.Complications surrounding Foley catheterizations represent a significant burden to the healthcare system.AIM To assess the demographic and patient characteristics surrounding urological consultation for difficult and traumatic Foley catheterizations at our institution across multiple hospitals.METHODS This is a single-institution,multi-hospital,263 patient,retrospective chart review from Jan 2020–December 2023.RESULTS The majority of consultations(80.2%)did not require heroic measures by the urology service.A Foley catheter placement was determined not difficult in the majority 191(72.6%)of patients.Sub-group analysis of“difficult by urology”vs“not difficult by urology”,showed a significant difference between those with zero attempts,one attempt,and greater than one attempts(P=0.004).Those patients specifically with greater than one attempts were more likely to be seen as a difficult insertion by urology assessment(60.6%)compared to not difficult(38.6%).Likewise,those patients with a history of difficult urethral catheter(DUC)/traumatic urethral catheterization(TUC)(25.8%)were more likely to be difficult compared to those without a history of DUC/TUC(14.2%)(P=0.038).CONCLUSION The study found that majority of consultations received did not require heroic measures by the urology service to place a catheter.Patients who had a history of DUC/TUC and those who had greater than one catheter attempts were statistically more likely to be a DUC based on urology assessment.At our institution we hope to propose a protocol in which nursing staff and non-urologic clinicians will utilize a troubleshooting checklist and an algorithm when difficult or traumatic urethral catheters are encountered in order to improve patient care and decrease healthcare costs.For example,this protocol would ideally address complications of multiple catheter attempts such as urethral trauma,development of urethral strictures,and infection risk.Additionally,future trainings and availability of additional resources will be provided and assessed with a goal of reducing healthcare cost surrounding these complications.
基金supported by grants from the National Nat-ural Science Foundation of China(82222012 and 82120108006)Scientific Innovation Program of Shanghai Municipal Education Committee(201901070007E00052)。
文摘Background:The choice of a basket or a balloon catheter during endoscopic retrograde cholangiopancreatography(ERCP)for the clearance of pancreatic duct stones in patients with chronic pancreatitis(CP)remains controversial.This study compared the efficacy and safety of these two devices for pancreatic duct stone extractions.Methods:We compared the efficacy and safety of basket and balloon catheters for pancreatic stone extractions.We enrolled CP patients who underwent ERCP for the first time at Changhai Hospital,Naval Medical University between February 2012 and December 2021.After propensity score matching(1:1),101 patients were included in each group.The primary outcome was the rate of pancreatic stone clearance.Secondary outcomes included the rate of adverse events during hospitalization,long-term pain relief,and quality of life after one year follow-up period.Results:The rate of complete clearance was comparable between the two groups(86.1%vs.84.2%,P=0.692).In patients with stones≥2 cm before extracorporeal shock wave lithotripsy(ESWL),the rate of complete clearance was significantly higher in the balloon catheter group when compared to the basket catheter group[100%(19/19)vs.70.0%(14/20),P=0.031].In the multivariate logistic analysis,ESWL prior to stone extraction was the only independent predictor of complete clearance[with ESWL 58.4%(264/452)vs.without ESWL 41.6%(188/452),odds ratio=2.3,95%confidence interval:1.2–4.3;P=0.013].No significant differences between groups were found regarding the rates of adverse events during hospitalization,quality of life,and pain relief after one year of follow-up.Conclusions:Basket and balloon catheters showed similar efficacy and safety for pancreatic stone extractions.However,the balloon catheter was superior to the basket catheter if the pancreatic stone size was≥2 cm before ESWL.
文摘BACKGROUND Peripherally inserted central catheters(PICCs)are crucial for patients requiring long-term intravenous therapy,especially within digestive surgery under bundled care protocols.AIM To evaluate and compare the efficacy,safety,and patient-reported outcomes of single-lumen vs double-lumen PICCs among patients undergoing digestive surgery within a structured bundled care framework.METHODS This retrospective cohort study analyzed data from 249 patients who underwent digestive surgery and utilized either single-lumen(n=117)or double-lumen(n=132)PICCs between January 2021 and June 2024.Clinical outcomes,patient satisfaction,catheterization duration,and complication rates were compared using statistical analysis via SPSS(version 29.0).The bundled care protocol was consistently applied,focusing on standardized procedures,staff training,and patient support.RESULTS Single-lumen PICCs were associated with a significantly lower thrombosis rate(0.85%)than double-lumen PICCs(6.82%,P=0.039).The single-lumen group experienced shorter catheterization durations(12.5±3.14 days vs 13.6±4.50 days,P=0.025)and higher successful infusion rates(92.7%±5.32%vs 90.4%±6.60%,P=0.003).This group also reported higher comfort scores(8.40±1.20 vs 7.90±1.50,P=0.004)and lower pain levels(2.90±0.70 vs 3.20±0.80,P=0.002).Aside from thrombosis,complication rates showed no significant difference between the groups.CONCLUSION Within bundled care context,single-lumen PICCs demonstrated advantages in reducing thrombosis risk,procedural efficiency,patient comfort,and satisfaction compared with double-lumen PICCs.The findings underscore the importance of considering patient-specific needs and clinical scenarios in catheter choice.
文摘Urinary catheters are essential medical devices widely used for patients requiring urinary drainage,bladder irrigation,or precise urine output monitoring.Transurethral catheters with anchoring balloons are particularly prevalent among hospitalized patients,facilitating continuous urinary drainage.
基金The Ili Kazakh Autonomous Prefecture Science and Technology Plan Project(Project No.:YJC2023A28)。
文摘Objective:Patients after radical gastrectomy often require medium-to long-term intravenous therapy.However,traditional central venous catheters(CVCs)have issues such as high infection risk and poor comfort.This study aims to deeply explore the clinical application value of peripherally inserted central catheters(PICCs)after radical gastrectomy,providing a scientific basis for optimizing intravenous access selection.Methods:Fifty patients requiring catheterization after radical gastrectomy at the Friendship Hospital of Ili Kazak Autonomous Prefecture from December 2022 to May 2024 were selected.Catheterization site selection was based on patients’preferences,dividing them into two groups:the experimental group receiving PICCs and the control group receiving CVCs,with 25 patients in each group.Multi-dimensional comparative analysis was conducted,including catheterization operation time,catheter indwelling time,success rates of first and second catheterizations,and complication rates.Statistical methods such as t-tests and chi-square tests were used for in-depth analysis.Results:Compared to the control group,the experimental group had longer catheterization operations and catheter indwelling times,and a higher success rate of first catheterization(P<0.05).The incidence of catheterization complications in the experimental group was 12.00%,lower than the 40.00%in the control group(P<0.05).Conclusion:Although PICC catheterization after radical gastrectomy has relatively longer catheterization operation and indwelling times,it has a high success rate of first catheterization and a low complication rate,demonstrating high clinical application value and worth promoting in clinical practice.
文摘BACKGROUND Long-term chemotherapy for patients with gastric cancer(GC),facilitated by peripherally inserted central catheter(PICC)catheterization,reduces vascular damage and enhances drug delivery efficiency but carries risks of catheter-related complications.A combination of group psychological nursing and physical mo-vement care significantly mitigates the risk of venous thrombosis and improves psychological well-being,and enhances motor function,underscoring its clinical importance.AIM To assess group psychological and physical movement nursing in preventing venous thrombosis in patients with PICC GC.METHODS Sixty-five GC patients with PICC,admitted from January 2022 to January 2023,were randomly divided into two groups using the lottery method:A control group(n=35,routine nursing)and an observation group(n=30,routine nursing plus psychological nursing and physical movement nursing).Both groups re-ceived continuous care for 2 weeks.Pre-nursing and post-nursing data on psycho-logical state,physical function,chemotherapy-related thrombosis incidence,and cancer-related fatigue were analyzed using SPSS 26.0 and GraphPad Prism 8.0.RESULTS After nursing,both groups showed reduced Hamilton Anxiety Scale scores and increased General Perceived Self-Efficacy Scale scores,with the observation group performing better(P<0.05).The Functional Comprehensive Assessment score for the observation group after nursing was(65.42±2.35)points,lower than the control group’s(62.19±4.33)points(P<0.05).Although no significant difference was observed in the incidence of venous thrombosis between the two groups(χ2=0.815,P=0.367),the observation group had lower incidence.Both groups showed decreased Revised Piper Fatigue Scale scores,with the observation group scoring lower(P<0.05).CONCLUSION Group psychological and physical movement nursing for patients with PICC reduces venous thrombosis risk,improves psychological well-being,cancer-related fatigue,and physical function,making it highly promotable.
文摘Persistent left superior vena cava(PLSVC)is a congenital anomaly where the left-sided vena cava,which usually regresses during fetal development,persists.Double superior vena cava resulting from a PLSVC is indeed a rare phenomenon.In the general population,the incidence of this condition is reported to be between 0.3%and 2.1%.[1]While this anatomical variation is often asymptomatic and discovered incidentally,it becomes relevant in certain clinical scenarios.Indeed,the presence of a PLSVC and double superior vena cava can pose challenges as incorrect positioning and result in failure.
文摘BACKGROUND Endoscopic retrograde cholangiopancreatography is a challenging procedure involving bile duct cannulation.Despite the development of several cannulation devices,none have effectively facilitated the procedure.AIM To evaluate the efficacy of a recently developed catheter for bile duct cannulation.METHODS We retrospectively examined 342 patients who underwent initial cholangiopan-creatography.We compared the success rate of bile duct cannulation and the incidence of complications between the groups using existing and novel catheters.RESULTS The overall success rates of bile duct cannulation were 98.3%and 99.1%in the existing and novel catheter groups,respectively(P=0.47).The bile duct cannulation rate using the standard technique was 73.0%and 82.1%in the existing and novel catheter groups,respectively(P=0.042).Furthermore,when catheterization was performed by expert physicians,the bile duct cannulation rate was significantly higher in the novel catheter group(81.3%)than in the existing catheter group(65.2%)(P=0.017).The incidence of difficult cannulation was also significantly lower in the novel catheter group(17.4%)than in the existing catheter group(33.0%)(P=0.019).CONCLUSION The novel catheter improved the bile duct cannulation rate using the standard technique and reduced the frequency of difficult cannulation cases,valuable tool in endoscopic retrograde cholangiopancreatography procedures performed by experts.
文摘Pulmonary embolism(PE)ranks as the third leading cause of cardiovascularrelated deaths in Western nations.Patients classified as high-risk(HR)-those exhibiting hemodynamic instability-require immediate interventions to restore blood flow.While intermediate–HR(IHR)individuals remain hemodynamically stable,they face a significant chance of clinical decline and thus need close and continuous observation.Effective risk assessment,mortality prediction,and therapeutic decision-making in these patients rely on a combination of clinical evaluation and imaging studies.Catheter-directed therapy(CDT)has emerged as a promising option,offering the ability to alleviate clot burden and reduce strain on the right ventricle,all while posing a lower risk of major bleeding compared to systemic thrombolysis.The growing adoption of CDT reflects its increasing relevance in PE treatment,especially when managed by specialized PE response teams that ensure individualized,multidisciplinary care.As clinical practices evolve,further studies and robust clinical trials are necessary to clearly define CDT’s role in lowering the risks of complications and death among IHR PE patients.This article explores the current understanding and future direction of managing PE,focusing in the role of catheter-based interventions.
文摘Atrial fibrillation(Afib)is a common arrhythmia with significant public health implications,affecting millions of individuals worldwide.Catheter ablation(CA)is an established treatment for drug-resistant Afib,yet recurrence remains a major concern,impacting quality of life in a significant portion of patients.Inflammation plays a critical role in the recurrence of Afib after ablation,with systemic inflammatory markers such as C-reactive protein being linked to higher recurrence rates.In this editorial,we discuss the study by Wang et al,published in the latest issue,which investigates the predictive role of the systemic immune inflammation index(SII)in Afib recurrence following radiofrequency CA.Elevated pre-ablation SII levels are identified as an independent predictor of recurrence,significantly enhancing the predictive power of the APPLE score.Integration of SII improved the APPLE score’s predictive performance,as shown by enhanced area under the curve,net reclassification improvement,and integrated discrimination improvement.This combined model highlights the importance of both structural and inflammatory factors in Afib recurrence,offering a more personalized approach to patient management.Additionally,the affordability and accessibility of SII enhance its practicality in clinical workflows.The study by Wang et al underscores the potential of integrating SII with existing scoring systems to refine risk stratification and optimize treatment strategies.Future research should validate these findings across diverse populations,explore limitations such as the potential influence of comorbidities on SII reliability,and investigate additional biomarkers to enhance predictive accuracy.
文摘The recurrence of atrial fibrillation(AF)in patients after successful radiofrequency catheter ablation(RFCA)appears to be an unresolved clinical issue and needs to be clearly elucidated.There are many factors associated with AF recurrence,such as duration of AF,male sex,concomitant heart failure,hemodynamic parameters,chronic obstructive pulmonary disease,hypertension,obstructive sleep apnea,hyperthyroidism,smoking and obesity.However,the inflammatory changes are strongly associated with electrical and structural cardiac remodeling,cardiac damage,myocardial fibrotic changes,microvascular dysfunction and altered reparative response.In this context,biomarkers reflecting the different stages of AF pathogenesis deserve thorough investigation.The authors of the retrospective study revealed that one-year recurrence rate of non-valvular AF in the high systemic immune inflammation(SII)index group was significantly increased compared to that of the low SII index group and provided additional predictive value to the APPLE.Furthermore,the authors suggest that this biomarker may help physicians to optimize the selection of AF patients and to develop a personalized treatment approach.In conclusion,the SII index may serve as a valuable indicator of recurrent AF in patients after RFCA and may be a biomarker with plausible predictive value for poor clinical outcomes.
基金Supported by the Discipline Promotion Program of Shanghai Fourth People’s Hospital,No.SY-XKZT-2021-2006.
文摘BACKGROUND Ultrasound-guided peripherally inserted central catheter(PICC)placement is vital for cancer therapy,but lidocaine infiltration faces limitations like puncture pain and vasospasm.AIM To assess the clinical efficacy of a no-pain intervention-combining compound lidocaine cream with warm compress-in reducing pain during ultrasound-guided PICC placement in cancer patients.METHODS A retrospective cohort study analyzed 88 cancer patients undergoing PICC placement(Shanghai Fourth People’s Hospital,2024).Patients were divided into control(lidocaine infiltration,n=44)and intervention(cream+warm compress,n=44)groups.Primary outcomes:Pain scores(numerical rating scale),procedural time,complications;secondary outcome:Satisfaction.RESULTS The intervention group showed significantly lower pain scores(1.2±0.4 vs 3.8±1.2,P=0.012)with comparable first-attempt success(95.5%vs 90.9%)and safety(P=0.672).Thermal activation of transient receptor potential vanilloid 1 channel enhanced drug penetration,achieving anesthesia within 8-10 minutes.Patient satisfaction reached 97.7%.CONCLUSION The combination of compound lidocaine cream with warm compress significantly alleviates procedural pain and enhances patient satisfaction during ultrasound-guided PICC placement in cancer patients,supporting its clinical application.
文摘Objective:To observe the intervention effect of clinical nursing pathway on patients receiving intravenous therapy via peripheral mid-long catheters.Methods:Ninety patients receiving intravenous therapy via mid-long catheters in the hospital from March 2024 to March 2025 were selected and randomly divided into a control group and an observation group,with 45 patients in each group.The control group received routine nursing intervention,while the observation group received clinical nursing pathway intervention.The nursing risk events,catheter indwelling time,and nursing satisfaction were evaluated in both groups.Results:The observation group had a shorter catheter indwelling time,fewer risk events during intravenous therapy(total incidence rate of 2.22%),and higher nursing satisfaction.Additionally,negative emotional feedback was reduced,and the SAS score(31.02±1.12)was lower in the observation group compared to the control group.There were significant differences between the two groups in all indicators(P<0.05).Conclusion:Applying the clinical nursing pathway during intravenous therapy via peripheral mid-long catheters can help ensure infusion safety,improve unstable emotional states,and promote high-quality service standards.
文摘Objective:To assess the effectiveness of a visual double-lumen bronchial catheter in teaching lung isolation skills to anesthesia resident trainees.Methods:Between September 2023 and September 2024,20 anesthesiology residents from Jiangsu Cancer Hospital were randomly divided into two groups:the visual double-lumen group(n=10)and the conventional double-lumen group(n=10).Randomization was achieved using a random number table.The study assessed several outcomes,including total intubation time,positioning time,one-time intubation success rate,intraoperative catheter displacement rate,surgeon satisfaction scores,and the incidence of postoperative complications(pharyngeal pain,hoarseness,and dry cough)within 24 hours.Results:The visual double-lumen group demonstrated superior results compared to the conventional double-lumen group in the following measures:total intubation time(70.2±11.8 s vs 224.9±35.6 s),positioning time(30.1±5.7s vs 176.6±26.4 s),one-time intubation success rate(85%vs 45%),intraoperative catheter displacement rate(10%vs 40%),surgeon’s intubation satisfaction score(8.10±1.07 vs 6.90±1.41),satisfaction score for pulmonary isolation(8.35±1.04 vs 6.55±1.36),and airway management satisfaction score(8.40±1.3 vs 6.70±1.34).Additionally,the incidence of postoperative pharyngeal pain(15%vs 45%),hoarseness(10%vs 40%),and dry cough(5%vs 35%)was significantly lower in the visual double-lumen group(all P<0.05).Conclusion:The visual double-lumen bronchial catheter significantly enhances the training of anesthesia residents in lung isolation by reducing intubation and positioning times,improving intubation success rate,increasing surgeon satisfaction,and reducing intubation-related complications.This method offers a more effective teaching approach compared to conventional techniques.
文摘Objective:To investigate the preventive effect of targeted nursing interventions on deep vein thrombosis in patients with hemodialysis catheter indwelling.Methods:A prospective study was conducted involving patients who underwent hemodialysis catheter indwelling and were admitted between August 2023 and August 2025,totaling 108 cases.These patients were randomly divided into two groups using a random number table method,with 54 cases in each group.The control group received routine nursing interventions,while the observation group received targeted nursing interventions.The incidence of deep vein thrombosis and hemodynamic indicators were compared between the two groups.Results:The incidence of deep vein thrombosis in the observation group was lower than that in the control group(p<0.05).After two weeks of nursing,the hemodynamic indicators in the observation group were higher than those in the control group(p<0.05).Conclusion:Targeted nursing interventions can effectively prevent deep vein thrombosis and improve hemodynamics in patients with hemodialysis catheter indwelling,making them worthy of clinical promotion.
基金Supported by the Shandong Province Medical and Health Technology Development Plan,No.202204011069.
文摘BACKGROUND Peripherally inserted central catheters(PICCs)are widely used for administering chemotherapy to breast cancer patients due to their long-term indwelling capability,versatility in drug administration,and flexibility.PICCs infection are a relatively common occurrence,yet there were no reported instances that it can metastasise to the lumbar spine.CASE SUMMARY This case report describes a breast cancer patient who developed a methicillinresistant Staphylococcus aureus lumbar vertebral infection secondary to a PICCrelated infection during chemotherapy.Following PICC removal,bacterial culture confirmed the presence of highly virulent methicillin-resistant Staphylococcus aureus.The patient presented with fever and severe lumbar pain.Lumbar magnetic resonance imaging revealed paraspinal muscle edema from L1 to L3 with abnormal signal intensity in the affected regions,suggestive of vertebral osteomyelitis.Prompt initiation of appropriate antibiotic therapy based on the culture results led to significant improvement in the patient’s lumbar pain.CONCLUSION This case highlights the importance of vigilant infection prevention and control measures to minimize the risk of PICC-related complications,such as bloodstream infections and subsequent metastatic infections.
文摘Background Atrial fibrillation(AF)and hypertension are closely related,with hypertension being a significant risk factor for the development of AF.The aim of this study was to investigate the gender differences in the effects of radiofrequency catheter ablation(RFCA)on blood pressure regulation in patients with paroxysmal atrial fibrilla-tion(PAF)and primary hypertension.Methods This prospective cohort study included 65 patients(44 males,21 females)with PAF and primary hypertension who underwent RFCA.Blood pressure was measured preoperatively and at 3 months postoperatively using 24-hour ambulatory blood pressure monitoring.Changes in blood pressure parameters were compared between male and female patients.Results Significant gender differences were ob-served in 24-hour mean systolic blood pressure(24h SBP)and daytime mean systolic blood pressure(dSBP).In male patients,24h SBP decreased by 5.16 mmHg,and dSBP decreased by 4.30 mmHg,while female patients showed minimal changes,with a decrease of 1.44 mmHg in 24h SBP and 0.39 mmHg in dSBP.These changes were significantly different between genders(P<0.001 for 24h SBP and P=0.005 for dSBP).No significant differences were found between males and females in other blood pressure parameters(P>0.05).Conclusions RFCA signifi-cantly improved blood pressure control in male patients with PAF and primary hypertension,with more pronounced reductions in 24h SBP and dSBP compared to female patients.These findings suggested that gender may influence the effectiveness of RFCA in managing blood pressure in this population,underscoring the importance of consider-ing gender when planning treatment strategies.
文摘Objective:To explore the evidence-based nursing optimization strategy for catheter tip positioning during peripherally inserted central catheter(PICC)insertion in patients with persistent left superior vena cava(PLSVC).Methods:For one ovarian cancer patient with PICC malposition in the coronary sinus(CS)due to PLSVC,multimodal imaging techniques were integrated to accurately locate the catheter tip.The catheter position was adjusted based on evidence(withdrawing 5 cm),and a standardized nursing process was established,including personalized health education,catheter fixation and displacement monitoring,complication monitoring,establishment of a specialized disease information archive system,and formulation of a follow-up plan.Results:The catheter tip was successfully withdrawn from the coronary sinus(at the T8 level)to the middle and lower part of the PLSVC(at the T6 vertebral level),and the catheter functioned normally after adjustment.No complications such as arrhythmia or thrombosis occurred during the 332-day chemotherapy period.Conclusion:The PICC tip in PLSVC patients should be positioned in the middle and lower part of the PLSVC(at the T5–T7 vertebral level).This new standard can effectively avoid CS-related complications.The integration of multi-modal imaging techniques and evidence-based nursing management are key to ensuring safe infusion.
文摘BACKGROUND Peripherally inserted central catheter(PICC)is the preferred intravenous route for chemotherapy in patients with cancer,but its complications,especially deep vein thrombosis(DVT),are becoming increasingly prevalent.Medical staff proficient in intubation and maintenance techniques can reduce complications.The multivariate integration teaching model applies the integration of“teaching learning application”to medical training,which helps shift the prevention of complications from“passive management of complications”to“active construction of risk immunity”,thereby ensuring foundational competency for PICC in patients with cancer.AIM To investigate the efficacy of the multivariate integration teaching model in patients with gastric cancer and concurrent DVT after PICC intubation and analyze its effect on patients’quality of life index(QLI)and satisfaction.METHODS A retrospective analysis of medical records of 100 patients with gastric cancer and PICC treated at Zhejiang Provincial People’s Hospital from May 2019 to November 2020 was conducted.According to the different treatment methods and teaching modes received by medical staff,they were divided into a control group and an experimental group,with 50 cases in each group.The routine clinical teaching model and the multivariate integration teaching model were administered to the medical staff for the control group and the experimental group,respectively,to compare the incidence rates of DVT and other adverse reactions,QLI scores,Karnofsky Performance Scale scores,Mental Status Scale in Non-Psychiatric Settings scores,patient satisfaction,medical staff’s test marks,and satisfaction evaluation of the teaching model.RESULTS Compared with the control group,the experimental group exhibited significantly lower incidence rates of DVT and other adverse reactions and MSSNS scores but significantly higher QLI scores,KPS scores,patient satisfaction,medical staff’s test marks,and their satisfaction evaluations of the teaching model(P<0.05).CONCLUSION In a single-center practice,performing the multivariate integration teaching model for medical staff may effectively improve the patients’QLI and satisfaction and may have certain application value in preventing DVT in patients with gastric cancer and PICC.
