Application value of high-pressure-resistant peripherally inserted central catheters in enhanced computer tomography of diabetic patients with malignant tumors.
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Abstract
Background: Individuals with diabetes mellitus have a higher risk of developing malignant tumors, and diagnosing these tumors can be challenging.
Aim: To confirm the benefits of using peripherally inserted central catheters (PICCs) in contrast-enhanced computerized tomography (CECT) for diagnostic imaging in diabetic patients with malignant tumors and to provide a research basis for follow-up research.
Methods: This retrospective study analyzed 204 diabetic patients with malignancies treated at The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, from January 2024 to June 2024. The patients were divided into two groups: A control group (n = 102) with indwelling peripheral intravenous catheters and a research group (n = 102) with high-pressure-resistant PICC. The study compared baseline data, the incidence of iodine contrast extravasation during CECT, the incidence of adverse events (discomfort, redness and swelling at the puncture site, and blood oozing), imaging quality, nursing time, intubation success rate, number of venipuncture attempts, and catheter maintenance cost.
Results: Male patients accounted for 51.96% in the control group and 55.88% in the research group; the average age was (59.68 ± 11.82) years in the control group and (61.41 ± 12.92) years in the research group; the proportions of lung cancer, colorectal cancer, and gastric cancer patients in the control group were 42.16%, 38.24%, and 19.61%, respectively, while those in the research group were 34.31%, 37.25%, and 28.43%, respectively. Except for the gender distribution, age, and cancer type mentioned above, other general information such as underlying diseases, puncture location, and long-term chemotherapy shows no significant differences as tested (P > 0.05). The results showed that the research group had significantly reduced incidence of iodine contrast extravasation (7 vs 1, P = 0.031), similar incidence of adverse events (11 vs 7, P = 0.324), reduced nursing time [(18.50 ± 2.68) minutes vs (13.26 ± 3.00) minutes, P = 0.000], fewer venipuncture attempts [(2.21 ± 0.78) times vs (1.49 ± 0.58) times, P = 0.000], lower catheter maintenance cost [(1251.79 ± 205.47) China yuan (CNY) vs (1019.25 ± 117.28) CNY, P = 0.000], increased intubation success rate (16.67% vs 58.82%, P = 0.000), and better imaging quality (85.29% vs 94.12%, P = 0.038).
Conclusion: High-pressure-resistant PICCs can lessen the physical burden of diabetic patients during nursing, reduce treatment costs, and improve the efficiency and quality of imaging for diagnosis malignant tumors.
背景：糖尿病患者发展为恶性肿瘤的风险较高，诊断这些肿瘤具有挑战性。目的：确认造影增强计算机断层扫描（CECT）中应用外周插入中心导管（PICCs）诊断糖尿病合并恶性肿瘤的益处，为后续研究提供研究依据。方法：对2024年1月至2024年6月在南昌大学江西医学院附属第二医院治疗的204例糖尿病恶性肿瘤患者进行回顾性研究。将患者分为两组：留置外周静脉导管的对照组（n = 102）和高压性PICC研究组（n = 102）。本研究比较了基线数据、CECT期间碘造影剂外渗发生率、不良事件发生率（穿刺部位不适、红肿、渗血）、影像学质量、护理时间、插管成功率、静脉穿刺次数、导管维护费用。结果：对照组男性患者占51.96%，研究组男性患者占55.88%；对照组平均年龄为（59.68±11.82）岁，研究组平均年龄为（61.41±12.92）岁；对照组肺癌、结直肠癌、胃癌患者比例分别为42.16%、38.24%、19.61%，研究组肺癌、结直肠癌、胃癌患者比例分别为34.31%、37.25%、28.43%。除上述性别分布、年龄、肿瘤类型外，其他基本信息如基础疾病、穿刺部位、长期化疗等经检验无显著差异（P < 0.05）。结果显示：研究组碘造影剂外渗发生率显著降低（7 vs 1, P = 0.031），不良事件发生率相近（11 vs 7, P = 0.324），护理时间缩短（18.50±2.68）min vs(13.26±3.00)min, P = 0.000)，静脉穿刺次数减少（2.21±0.78）次vs（1.49±0.58）次，P = 0.000)，导管维持费用降低（1251.79±205.47）元vs（1019.25±117.28）元，P = 0.000。插管成功率提高（16.67% vs 58.82%, P = 0.000），显像质量提高（85.29% vs 94.12%, P = 0.038）。结论：抗高压PICCs可减轻糖尿病患者护理过程中的身体负担，降低治疗费用，提高恶性肿瘤的影像学诊断效率和质量。
期刊介绍：
The WJD is a high-quality, peer reviewed, open-access journal. The primary task of WJD is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of diabetes. In order to promote productive academic communication, the peer review process for the WJD is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJD are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in diabetes. Scope: Diabetes Complications, Experimental Diabetes Mellitus, Type 1 Diabetes Mellitus, Type 2 Diabetes Mellitus, Diabetes, Gestational, Diabetic Angiopathies, Diabetic Cardiomyopathies, Diabetic Coma, Diabetic Ketoacidosis, Diabetic Nephropathies, Diabetic Neuropathies, Donohue Syndrome, Fetal Macrosomia, and Prediabetic State.
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