摘要
目的比较经外周静脉置入中心静脉导管(PICC)、经颈内静脉植入输液港(胸壁港)及经上臂静脉植入输液港(上臂港)对乳腺癌化疗患者生活质量的影响。方法采用方便抽样法选取2018年11月至2019年6月在北京市2所三级甲等综合医院乳腺科的342例乳腺癌化疗患者作为研究对象,使用一般资料调查表及健康相关生活质量量表进行调查,比较置入不同中心静脉通路的患者生活质量的差异。结果更多自费(10.2%)或新农合(16.2%)患者选择PICC作为化疗通路,且PICC患者带管时间[66(44,113)d]较胸壁港[130(68.5,325.5)d]和上臂港[184(65,323)d]更短(P<0.001)。更多靶向治疗患者选择上臂港(49.5%)或胸壁港(48.4%)作为治疗通路(P=0.002)。PICC患者的生理机能[75(65,80)分]、生理职能[0(0,0)分]、社会功能[44.4(33.3,66.7)分]、情感职能[0(0,66.7)分]以及生理健康[216(192,241)分]、心理健康[211.7(190.4,256.9)分]得分较胸壁港[分别为85(75,90)分、25(0,100)分、77.8(55.6,100)分、100(0,100)分、256(191,314)分、306.9(211.9,359.8)分]和上臂港[分别为80(75,90)分、50(0,100)分、88.9(55.6,100)分、100(0,100)分、277(199,356)分、319.8(235.8,360.9)分]更差(P均<0.05),PICC患者一般健康状况得分[57(50,72)分]低于上臂港[72(50,85)分,P<0.05]。结论使用PICC化疗的患者生活质量低于使用输液港化疗的患者,而不同部位置入输液港的患者生活质量差异不大。输液港是乳腺癌化疗患者的优选通路。
Objective To compare the quality of life of breast cancer patients on chemotherapy via peripherally inserted central catheter(PICC),chest port,and arm port.Methods From November 2018 to June 2019,totally 342 breast cancer patients undergoing chemotherapy were recruited by convenient sampling method at two tertiary hospitals in Beijing,and general characteristics questionnaire and Short Form 36 health survey questionnaire(SF-36)were administered.The quality of life of patients with different approaches to central venous access was compared.Results More patients in the PICC group were self-paying or covered by the new rural cooperative medical system(16.2%vs 10.2%,P<0.001).Patients who accepted targeted therapy preferred to choose arm port or chest port as venous access(P=0.002).Patients in the PICC group[66(44,113)d]had shorter catheter-indwelling time than those with chest port[130(68.5,325.5)d]and arm port[184(65,323)d](P<0.001).The scores of physical functioning[75(65,80)],role physical[0(0,0)],social functioning[44.4(33.3,66.7)],role emotional[0(0,66.7)],physical health[216(192,241)],and mental health[211.7(190.4,256.9)]of SF-36 were significantly lower in the PICC group than in the chest port group[85(75,90),25(0,100),77.8(55.6,100),100(0,100),256(191,314),and 306.9(211.9,359.8),respectively]and arm port group[80(75,90),50(0,100),88.9(55.6,100),100(0,100),277(199,356),and 319.8(235.8,360.9),respectively;P<0.05];The score of general health of SF-36 was significantly lower in the PICC group[57(50,72)]than in the arm port group[72(50,85),P<0.05].Conclusion Patients using port as chemotherapy path have better quality of life than patients with PICC,while there is little difference in quality of life between patients using ports inserted through different sites.Port might be a better approach to venous access for breast cancer patients undergoing chemotherapy.
作者
王影新
刘飞
张军军
赵璇
赵权萍
刘倩
Wang Yingxin;Liu Fei;Zhang Junjun;Zhao Xuan;Zhao Quanping;Liu Qian(Department of General Surgery,Peking University First Hospital,Beijing 100034,China)
出处
《中华临床医师杂志（电子版）》
CAS
2020年第5期349-354,共6页
Chinese Journal of Clinicians(Electronic Edition)
关键词
乳腺癌
药物疗法
导管插入术
中心静脉
生活质量
Breast cancer
Drug therapy
Catheterization
central venous
Quality of life
