Catheter-associated infection and influencing factors in anti-tumor chemo-therapy treated patients after indwelling peripherally inserted central ca-theter:analysis based on random forest model / 中国感染控制杂志

Objective To analyze the influencing factors for catheter-associated infection(CAI)in chemotherapy treated patients after indwelling peripherally inserted central catheter(PICC)based on a random forest model.Methods 400 tumor patients who received chemotherapy and PICC were selected and divided into the training set(n=300)and the test set(n=100)in a 3∶1 ratio through computer-generated random number.Patients in the training set were subdivided into the non-infection group and the infection group based on the occurrence of infec-tion.Clinical data from two groups of patients were compared.Influencing factors for the occurrence of CAI after PICC were analyzed with multivariate logistic regression model and the integrated classification algorithm of random forest model,and the predictive performance of the two methods was compared.Results Among 300 chemotherapy treated patients in the training set,32 cases(10.67％)experienced CAI.Compared with the non-infection group,patients in the infection group had more single punctures for catheterization,longer PICC retention time,larger pro-portion of catheter movement,larger proportion of complication with diabetes,higher frequency of dressing chan-ges,lower white blood cell count and immune function(all P＜0.05).PICC retention time,catheter movement,complication with diabetes,dressing change frequency,white blood cell(WBC)and immune function were inde-pendent influencing factors for CAI after PICC(all P＜0.05).The random forest model showed that ranking by the importance of different influencing factors was as following:PICC retention time,catheter movement,complication with diabetes,WBC,dressing change frequency and immune function.The integrated classification algorithm of random forest model for predicting the occurrence of CAI in chemotherapy treated patients showed that the area un-der the receiver operating characteristic(ROC)curve(AUC)was 0.872,which had better prediction performance compared with the logistic regression model(AUC=0.791).Conclusion PICC retention time,catheter movement,complicated with diabetes,dressing change frequency,WBC level and immune function are independent influencing factors for CAI in chemotherapy treated patients.The integrated classification algorithm of random forest model can be used to predict CAI in chemotherapy treated patients,and its prediction performance is better than that of the logistic regression model.

Application and research of painless diagnosis and treatment technology in ultrasound-guided PICC catheterization in children / 中国现代医生

@#Objective To explore the application of painless diagnosis and treatment technology in children's peripherally inserted central catheter(PICC)guided by ultrasound.Methods Totally 82 children who planned to undergo PICC in the hospital from January 2021 to January 2023 were selected and randomly divided into a control group and an observation group using a random number table method,with 41 cases in each group;The control group underwent conventional ultrasound guided PICC catheterization,while the observation group underwent painless diagnostic and therapeutic techniques using ultrasound guided PICC catheterization;Compare the success rate of catheterization,completion time of catheterization,degree of pain in the child pain[children's pain behavior scale(FLACC)],tolerance[Houpt behavior scale(HBS)],compliance[Frankl scale(FCS)],and family satisfaction between the two groups.Results The success rate of catheterization in the observation group was higher than that in the control group,and the catheterization time was shorter than that in the control group,with a statistically significant difference(P<0.05).The FLACC score of the observation group was lower than that of the control group,while the HBS score and FCS score were higher than those of the control group,with a statistically significant difference(P<0.05);The total satisfaction of family members in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).Conclusion The use of painless diagnosis and treatment technology in ultrasound-guided PICC catheterization in children can improve the success rate of catheterization,shorten the catheterization time,reduce the degree of pain in children,enhance tolerance and compliance,and improve family satisfaction.

Choice of intravenous infusion route for parenteral nutrition / 中华临床营养杂志

Parenteral nutrition can be delivered by peripheral venous catheterization (PVC) and central venous catheterization (CVC).While PVC is the first choice for parenteral nutrition in most cases,CVC represents a better option in the case of high osmotic pressure (＞900 Osm/L) or prolonged nutritional support (＞ 14 days).Percutaneous central venous catheterization through subclavian vein is advisable for critical patients,but its indwelling time should be kept under 30 days.Peripherally inserted central catheterization,with low risk of lesion and infectious complications,is recommended by Chinese guidelines for elderly patients.Implanted port provides reliable rout for patients who need long-term intravenous treatment,including parenteral nutrition.Patients with such device enjoy more freedom in daily life and better quality of life.When choosing intravenous infusion route,we need to take into consideration the patient's condition,desire and treatment time.Standardized application of catheterization is key to the safety of its use.

Study on the effects of two different routes of intravenous administration on mannitol induced phlebitis / 中国生化药物杂志

Objective To study and analyze the effects of two different routes of intravenous administration on mannitol induced phlebitis. Methods 98 patients who received mannitol infusion in the first people's hospital in Wenling from December 2013 to December 2016 were selected as the study objects. The patients were divided into PICC group and peripheral group according to different intravenous administration modes. In group PICC, 49 cases were given intravenous administration by PICC. In peripheral group, 49 cases were received peripheral vein indwelling needle. The incidence of phlebitis in the two groups was compared. Results The data showed that the incidence of phlebitis in group PICC was 8.16%, and the incidence of phlebitis in peripheral group was 22.45%. The difference between the two groups was statistically significant (P<0.05). Conclusion Mannitol infusion by PICC can reduce the incidence of phlebitis.

Observation of high concentration potassium chloride infusion by micro pump through peripheral vein together with fluid infusion / 中国实用护理杂志

Objective To explore the feasibility of high concentration potassium cbloride infusion by micro pump through peripheral vein together with fluid infusion.Methods 160 patients were divided into the observation group A and B (each with 40 patients) and the control group(80 patients).For the control group,only high concentration potassium chloride was infused by micro pump through peripheral vein,high concentration potassium chloride pumped through peripheral vein together with 5％ sodium chloride and dextrose injection were adopted in the observation group A.High concentration potassium chloride pumped through peripheral vein together with medication liquid were adopted in the observation group B.The rate of pain and phlebitis in three groups were observed.Results The rate of pain and phlebitis decreased significantly in the observation groups compared with those of the control group.There was no significant difference in the rate of phlebitis between the observation group A and B.Conclusions High concentration potassium chloride infusion by micro pump through peripheral vein together with fluid infusion are more effective to alleviate pain,reduce the rate of phlebitis,and can change the kind and drip rate of the fluid based on the condition of the patients.

Study on the application of central vein and peripheral catheterizations in the chemotherapy of malignant tumor / 重庆医科大学学报

0.05).Medium time of keeping catheter in the first graup were 91 days and the second 5 days(P

Observation on the Safety and Efficacy of Alanyl-glutamine Dipeptide in Patients after Gastrointestinal Operation / 中国药房

OBJECTIVE:To investigate the safety and efficacy of alanyl-glutamine dipeptide administered via peripheral vein total parenteral nutrition(TPN)in patients after gastrointestinal operation.METHODS:64cases after gastrointestinal operations were randomly divided into routine TPN group(control group)and TPN plus alanyl-glutamine dipeptide group(therapeautic group),all of which were treated with the corresponding medicines from the first day to the7th day after oper?ation.RESULTS:The levels of both seralbumin and prealbumin rebounded on the8th day after operation with those of the control group rebound more slowly,significant differences were noted between the2groups(P

Nutritional support by the way of peripheral vein in the patients with severe acute pancreatitis / 肠外与肠内营养

Objectives:To investigate the effects of nutritional support by the way of peripheral vein(PV) in the patients of severe acute pancreatitis(SAP). Methods:The treatment results of nutritional support by the way of PV was observed retrospectively within the latest eight years in the patients of SAP. Results:31 cases were cared,and no complications relating to the use of PV in TPN happened. Conclusions:Nutritional support is an important and effective treatment in SAP patients,and the use of PV is an effective and safety route.

Comparison of with two different routes of thrombolytic therapy for deep venous thrombosis / 中国普通外科杂志

Objective To discuss the clinical effect of two different routes of thrombolysis for the treatment of acute deep vein thrombosis (DVT).Methods A total of 126 patients with DVT during December 2005 to March 2010 were randomly divided into two groups:(1)transcatheter popliteal vein thrombolysis method (group A);(2)thrombolysis therapy via peripheral vein (group B).The venous patency score and patency improvement were observed by venograms or Duplux.Results After treatment,the reduction rate of edema of leg (0.82?0.14)% and of thigh(0.89?0.07)%,and the venous patency improvement rate (55.41?3.21)% in group A were significantly higer than those in thrombol group B(0.63?0.11)%,(0.57?0.09)%and (32.34?3.77)%,respectively (all P