Patients with tumors undergoing long-term intravenous chemotherapy or brain metastases with edema requiring frequent infusion of dehydrating drugs often have poor peripheral venous conditions. When patients are expected to undergo long courses of chemotherapy or have difficulty with peripheral venipuncture, or need total parenteral nutrition due to malignant intestinal obstruction, central venous access is often established. This article compares indwelling needle, CVC (internal jugular vein), PICC, and infusion port technologies with respect to the cost of the indwelling method, the cost of the maintenance method, and the complications, in the hope that they will be useful for the clinical work of oncology colleagues. CVC (centralvenous catheter) is inserted into the superior and inferior vena cava through an internal jugular, subclavian, or femoral venous puncture and retained to provide convenient venous access. Cost: 600 to 800?yuan, maintenance about?20 yuan/day Duration: about 2 to 4 weeks, longer time is prone to infection Location: right side of the neck, internal jugular, subclavian, femoral veins Method: done by specially trained medical staff or anesthesiologists at the time of surgery. The catheter is inserted directly from the internal jugular vein into the superior vena cava and fixed in place. The needle is inserted directly into the heparin cap during the infusion. The tube is sealed with 10mL of 0-10U/mL heparin saline after daily infusion. Advantages: less difficult to operate. Disadvantages: short retention time,?CVC, high risk of dislodgement, inconvenient care, poor comfort. Complications: pneumothorax, hemothorax, air embolism, blood, swollen brachial plexus nerve, thoracic catheter injury, catheter ectopic, fractured tube, myocardial perforation, arrhythmia, arterial perforation. Thrombosis-related risk: high Infection-related risk: highest PICC PeripherallyInserted CentralCatheter (PICC) is a catheter inserted by puncture of a peripheral vein with the head end in the superior vena cava or subclavian vein and used to provide medium- to long-term intravenous fluid therapy to patients (7 days to 1 year) Cost: 2000 to 3000?yuan, maintenance about ?70 to 80?yuan per visit Duration: several months, can be up to ?1 year Department: elbow, noble vein, median elbow vein, cephalic vein Method: done by specially trained health care professionals. Mostly using the?Seldinger puncture method, a central venous catheter is introduced into the superior vena cava by a guide wire. The needle is inserted directly into the heparin cap during the infusion. After infusion, the tube is sealed with saline?10mL pulsed with 0-10U/mL heparin saline 20mL. Not commonly recommended to flush and change once a week (20mL NS flush tube, heparin saline 3~5mL seal tube) Advantages: relatively cheap, relatively simple operation and care, convenient drug administration, does not affect normal activities Disadvantages: short retention time, superficial veins are not suitable for long-term chemotherapy and nutrient infusion. Complications: arrhythmia, ? arterial perforation, air embolism (rare), fractured tubes, myocardial perforation. Thrombosis-related risk: high, ?40%? or even higher Infection-related risk: high Infusion port An infusion port (implantablevenousaccessport, PORT) is a closed infusion device that is completely implanted in the body and includes a catheter portion with the tip in the superior vena cava and an injection seat that is embedded under the skin. Cost:$6,000-8,000?yuan, maintenance about?200 yuan/month Duration: can be used for a long time, suitable for treatment needs of?6 months or more. Department: Anterior chest subcutaneous, subclavian vein Method: Mostly done by anesthesiologists in the operating room under local anesthesia. The infusion port is placed under the skin of the anterior chest, with the anterior end of the catheter in the superior vena cava and the posterior half subcutaneously in the chest wall. A butterfly needle is inserted into the infusion port to establish central venous infusion access. The infusion is first pulsed with ?NS 20 mL and sealed with 50-100 U/mL heparin saline 5 mL. For infrequent use, flushing every 4 weeks is recommended (20mL NS pulse and 3 to 5mL?seal with heparin saline). Advantages: no increase in overall cost for long-term use, can be used for blood sample collection, aesthetic and convenient, can live and work normally, currently the best way for patients treated with chemotherapy for malignancy including long-term parenteral nutrition. Disadvantages: high cost of placement, trauma to both placement and removal. Complications: catheter ectasia, catheter dislodging from the?DDS articulation and causing catheter entry into the superior vena cava or right atrium, arrhythmias, arterial perforation, air embolism, fractured tubes, myocardial perforation. Thrombosis-related risk: low Infection-related risk: low Intravenous indwelling needle Cost: 60 to 80 yuan/time, maintenance about ?20 yuan/day Duration: 72 to 96?hours Department: superficial veins of the extremities (forearm preferred) Method: routine operation, done by the nurse. The needle is inserted directly into the heparin cap during infusion. Daily infusion followed by 50~100U/mL?heparin saline 5~10mL to seal the tube or special sealing solution pulsed positive pressure to seal the tube. Advantages: less difficult to operate. Disadvantages: short retention time, superficial veins are not suitable for long-term chemotherapy and nutrient infusion. Complications: subcutaneous hematoma Thrombosis-related risk: low, not serious Infection-related risk: low