In fact, most chemotherapy drugs are severely irritating and corrosive, and need repeated infusion for treatment. If chemotherapy drugs are repeatedly infused through peripheral veins, the drugs are very irritating to human peripheral blood vessels, which may cause problems such as difficulty in venipuncture, phlebitis and peripheral blood vessel atrophy. Moreover, once the chemotherapeutic drugs are extravasated, it may cause serious skin necrosis and cause double harm to the patient's body and mind. Therefore, chemotherapy infusion is far more than just hanging water.
Central venous infusion is a safe infusion method for chemotherapy, and it is also the main and preferred infusion method for chemotherapy at present. In this method, a catheter is directly placed near the great vessels of the heart, and chemotherapy drugs directly enter the great vessels through the catheter without passing through the peripheral veins.
PICC will insert a catheter from the upper arm blood vessel. One end of the catheter enters the central vein, close to the heart, and the other end is exposed and wrapped with plastic film. When in use, the nurse connects the infusion set to the exposed catheter, and the liquid medicine enters the blood vessel through the catheter.
The catheter end of Port also enters the central vein, close to the heart. Unlike PICC, catheters enter from larger veins, such as jugular vein, subclavian vein and femoral vein. The other end of the catheter is connected with a medicine box. The whole catheter and medicine box are completely buried under the skin (usually under the skin of the chest wall), and no catheter is exposed on the body surface. When in use, the nurse inserts the infusion needle into the medicine box buried under the skin, and the liquid medicine enters the medicine box through the needle.
For example, patients with bilateral breast cancer, affected by axillary lymph node dissection, generally do not consider PICC implantation, it is recommended to directly choose port implantation; If the patient's platelets are low and easy to bleed, it is recommended to implant PICC catheter. If both methods are suitable, patients can decide which catheter to choose according to their own situation and the characteristics of the two catheters. Comparison of two infusion methods;
In our hospital, PICC catheter implantation is handled by our PICC catheter center, which has rich experience in PICC catheter placement and maintenance for more than 10 years, and has ultrasound-guided venipuncture, which effectively improves the success rate of PICC catheter placement.
Port implantation is performed by doctors in the operating room. Blood routine and coagulation function should be improved before operation. The operation time can usually be completed within half an hour. There is no need to stay in hospital for observation. Infusion can be used for implantation on the same day. The wound was about 2-3cm long and had 2-3 stitches. The dressing can be changed in the clinic in about 3 days, and the stitches can be removed in 10 days.
Taking the operation in our hospital as an example, since the operation of Port was carried out in 2007, more than 2,000 cases of Port have been safely implanted without serious complications.
Malignant tumor has been classified as a chronic disease by the World Health Organization (WHO), and the treatment of tumor will have a long way to go. On this long anti-cancer road, PICC and Porter two central venous infusion modes can not only effectively escort tumor patients to complete chemotherapy safely and comfortably, but also meet the venous access needs of tumor patients who need long-term intravenous nutrition support, adding another guarantee for tumor patients in the anti-cancer struggle!
Associate professor, deputy chief physician, doctor of surgery, tutor of master students.
Deputy Director of Anorectal Surgery, Sixth Affiliated Hospital of Sun Yat-sen University
Young Member and Secretary-General of the Professional Committee of Colorectal and Anorectal Diseases of China Society of Integrated Traditional Chinese and Western Medicine
China medical doctor association anorectum professional Committee deputy director physician assessment branch
Member of the Third Council of World Zhonglian Anorectal Disease Professional Committee
Member of TEM (minimally invasive anorectal surgery) group of colorectal cancer professional committee of China Anti-cancer Association.
Member of the Working Committee of Gastrointestinal Surgeons of Guangdong Medical Association.
Medical expert member of South China Medical Association of Guangdong Clinical Medical Association.
European Journal of Gastroenterology. Hepatology
Colorectal examination technique
He is good at the diagnosis and treatment of anorectal benign and malignant diseases, pelvic floor diseases, intractable constipation, complicated anal fistula, hemorrhoids, anal fissure and colorectal benign and malignant tumors.