头颈部肿瘤同步放化疗中应用PICC行肠外营养的临床研究

目的研究头颈部肿瘤同步放化疗患者经外周静脉行中心静脉置管(PICC)途径行肠外营养支持的可行性和安全性。方法选择头颈部肿瘤同步放化疗患者36例,超声引导下行PICC后进行肠外营养,统计PICC穿刺的成功率、完成同步放化疗的患者数,并观察PICC的不良反应。结果超声引导下置管成功率高,PICC不良反应发生率低。32例经PICC营养支持下完成同步放化疗,2例治疗中因PICC不良反应改用经胃管营养(1例出现静脉血栓、1例插管部位疼痛),2例因放化疗不良反应未完成治疗。结论头颈部肿瘤同步放化疗中,经PICC途径行肠外营养有效、安全,可有效协助抗癌治疗的进行。

The feasibility and safety of PICC for parental nutrition during the concurrent chemoradiotherapy of head and neck cancer

Objective To observe the clinical feasibility and safety of peripherally inserted central catheters（PICC） for parental nutrition during concurrent chemoradiotherapy in patients with head and neck cancer.Methods Thirty-six cases with head and neck cancer who had received concurrent chemoradiotherapy were selected.All patients received ultrasound-guided PICC for parenteral nutrition,and were rated for the success rate of PICC puncture and the number of cases who had finished their treatment.Side effects of PICC were also observed.Results Ultrasound-guided PICC has a higher success rate and a lower incidence of complications.Thirty-two cases completed concurrent chemoradiation with parenteral nutrition support by PICC;2 cases abandoned treatment for adverse reactions;2 cases switched to using gastric tube for nutrition support due to complications of PICC（vein thrombosis developed in one case,pain at intubation site in another）.Conclusions For concurrent chemoraidotherapy in the head and neck cancer,PICC for parental nutrition is safe,effective and helpful in the treatment.