PICC与TIVAP在脑胶质瘤患者中的应用比较

目的 比较经外周静脉穿刺的中心静脉导管（peripherally inserted central venous catheter，PICC）与完全植入式静脉输液港（totally implantable venous access port，TIVAP）在脑胶质瘤患者中的应用差异。方法 回顾性分析2016年1月至2022年10月在杭州市肿瘤医院行PICC或TIVAP置管的130例脑胶质瘤患者的临床资料，根据置管方式将其分为PICC组（55例）和TIVAP组（75例），比较两组患者置管前后1周血浆D-二聚体（D-dimer，D-D）水平变化、导管相关总并发症、一次性置管成功率、因导管并发症拔管率和导管留置时间。结果 置管后1周，PICC组患者的D-D水平显著高于本组置管前1周和TIVAP组（P<0.05）；TIVAP组患者置管前后的D-D水平比较差异无统计学意义（P>0.05）。TIVAP组患者的导管相关并发症发生率、因导管并发症拔管率均显著低于PICC组，一次性置管成功率显著高于PICC组，导管留置时间显著长于PICC组（P<0.05）。结论 脑胶质瘤患者PICC置管后1周D-D水平升高，在该时段应加强深静脉血栓防治管理。与PICC相比，TIVAP对D-D水平影响较小，临床应用效果更好，值得广泛推广。

Comparison of PICC and TIVAP in patients with brain glioma

Objective To compare the application difference between peripherally inserted central venous catheter (PICC) and totally implantable venous access port (TIVAP) in brain glioma patients. Methods The clinical data of 130 patients with brain glioma who received PICC or TIVAP catheterization in Hangzhou Cancer Hospital from January 2016 to October 2022 were retrospectively analyzed, and they were divided into PICC group (55 cases) and TIVAP group (75 cases) according to the catheterization method. The changes of plasma D-dimer (D-D) level one week before and after catheterization, total catheter-related complications, the success rate of one-time catheterization, extubation rate due to catheter complications and catheter indwelling time were compared between two groups. Results One week after catheterization, D-D level in PICC group was significantly higher than that before catheterization and TIVAP group (P<0.05). There was no significant difference in D-D level in TIVAP group before and after catheterization (P>0.05). The rate of catheter-related complications and extubation rate due to catheter complications in TIVAP group were significantly lower than those in PICC group, the success rate of one-time catheterization was significantly higher than that in PICC group, and the catheter indwelling time was significantly longer than that in PICC group (P<0.05). Conclusion D-D level in brain glioma patients increased one week after PICC catheterization, and the prevention and treatment of deep vein thrombosis should be strengthened during this period. Compared with PICC, TIVAP has less effect on D-D level and better clinical application effect, which is worthy of widespread promotion.