The need for long-term intravenous indwelling devices: a large number of patients who need to receive repetitive infusion therapy
1.Anti-tumor systemic chemotherapy
2.Analgesic treatment
3.Antibiotic therapy
4.External digestive tract nutrition
5.Blood products/blood derivatives infusion
Repeated punctures and drug effects lead to peripheral veins unsuitable for puncture resulting in increasing physiological as well as psychological trauma to patients, especially for children (phlebitis)
Current main infusion tools: scalp needles, cannula indwelling needles, central venous catheters (CVC), peripheral central venous catheters (PICC), subcutaneous buried infusion ports (port)
PICC characteristics: Picc is central venous catheter is inserted via peripheral (cephalic or noble vein)
Advantages.
1.Easy to implant, bedside finish
2, relatively low infection, retention time 6-12M
3, moderate cost, easily accepted by patients
Disadvantages.
1, abnormal position of catheter tip
2, potential bacteremia: high demand for care
3.Impact on aesthetics, poor quality of life (QOL)
4. Difficult to place in obese patients
5.Conventional placement position
Care of PICC
1.The tube must be flushed before and after each use, and must be sealed after use
2.Dressing and heparin cap should be changed once a week
3. Flush the tube once a week
4.The workload of nurses increases!
PORT features: can cope with the bustling flow of passengers and cargo, quiet and peaceful
Advantages.
1.Exact CVC access
2.High indications
3.Easy care
4, Anti-infection, low complications
5, aesthetic, high QOL
Disadvantages: relatively expensive
Implantation techniques
1.Venipuncture technique
2.Basic surgical technique
3.Catheter implantation under DSA
4.Venous under ultrasound localization
Venous implantation techniques
1.Surgical route (children)
2.Percutaneous puncture route: Seldinger method
Modified Seldinger method
Over-the-wire method
Braunule method
Seldinger method
OTW method
DSA and ultrasound
1.Vascular localization
2.Guided puncture
3.Catheter position localization
4.Follow up