Breast cancer patients are treated with PICC catheterization PICC is a central venous catheter with peripheral cannulation, which is inserted through the peripheral vein at the front of the elbow and travels along the vessel to reach the superior vena cava. PICC can be used to infuse drugs directly into the central vein with fast vascular flow and high blood flow, avoiding vascular damage caused by long-term infusion or infusion of highly concentrated and strongly stimulating drugs, reducing the pain caused by repeated venipuncture, ensuring smooth treatment with fewer complications, and reducing the incidence of phlebitis in chemotherapy patients and alleviating their pain. Operation method: The puncture kit contains 1 silicone catheter, tearable trocar needle, skin ruler, transparent film and skin disinfectant. Sterile gloves and sterile heparin saline are also provided. Measure the length of the cannula. The patient is lying flat, and the puncture vein is selected (your vein, median elbow vein, and cephalic vein are all acceptable,) and the arm on the puncture side is abducted at 90°, measured from the puncture point along the course of the vein to the right sternoclavicular joint, and then down to the second rib space. Sterilize the puncture site, 10-15 cm in diameter, wearing sterile gloves and spreading sterile towels. Preflush the catheter and puncture needle with heparin saline, puncture with a tearable trocar needle, see blood return and then depress the angle and then enter the needle 2-3 cm, confirm that the guide trocar is in the vessel, withdraw the needle core, and feed the catheter evenly and slowly into the central vein until the measured length. Aspirate the blood back to confirm that the catheter is in the vein, tear the guiding cannula and withdraw the guidewire, install the heparin cap or cortisol connector, seal the cannula with dilute heparin solution under positive pressure, and compress the puncture site. Clean the area with alcohol, cover the puncture site with 4-6 layers of small square gauze under pressure to stop bleeding, and cover it with sterile transparent film. Care: Before placement, explain the purpose and necessity of the tube to the patient or family, and provide the necessary psychological care during placement and retention to eliminate patient tension and obtain the understanding and support of the patient and family. Understand the patient’s coagulation function and blood viscosity before the operation to prevent more than blood leakage from the puncture site and catheter obstruction after the placement. After placement of the catheter, closely observe whether the puncture point is oozing and swollen within 24h, and touch the puncture point for pain and hard nodes. Check daily whether the catheter is properly fixed, and whether it is folded or loose. If the catheter is partially dislodged, it should not be infused with highly concentrated and hypertonic solution, but it does not affect the purpose of catheter placement, and it can be fixed locally, but it should not be sent into the blood vessel again to prevent infection. The transparent dressing should be changed once a day for 3 days after puncture and twice a week thereafter. When replacing the transparent dressing, the dressing should be lightly torn along the direction of blood flow to prevent the catheter from being taken out; disinfect the skin with iodophor by rotating from the puncture point outward, and pay attention to the disinfection of the exposed catheter when disinfection is carried out; if the dressing is found to be contaminated, moist or falling off, it should be replaced in time. Observe the drip rate of infusion daily and check whether the pipeline is smooth. If the drip rate is slowing down, there may be poor pipeline and blockage, use 10ml of heparin solution (1ml of sodium heparin plus 100ml of saline) to pump, then relax and make full contact between heparin solution and thrombus by negative pressure, push while pumping, and so on several times; if the blood is still not returned, the catheter can be closed for 30min, let the thrombus soak in the thrombolytic solution as much as possible, and then pump, the blocked lumen will be more The obstructed lumen will be unblocked. Seal the tube with positive pressure of heparin saline after each infusion. If infusion of viscous drugs such as 20% mannitol, fatty milk, etc., seal the tube after flushing with 10ml of saline. If you find any unexplained fever, you should consider that it may be caused by the catheter, especially if the catheter has been in place for a long time. This method is routinely used in our breast surgery department for ductal chemotherapy of breast cancer patients.