Application Of VPA And PICC In The Treatment Of Patients With Malignant Tumors And Its Comparative Clinical Study

Chemotherapy of malignant tumors has great injury both on the patient’s physicaland psychological status, most patients who became early termination ofchemotherapy because they can not endure the pain of chemotherapy any more. Thedifferent way of intravenous catheter play a very important role in the probability ofinfection, the incidence of infection, and the quality of life in patients with malignanttumors. However, there is relatively few studies in domestic about the comparison ofPeripheral Insert Center Venous Catheter（PICC）and Central Verlous Port Accesssystem（VPA）, and more rarely for intravenous catheter service satisfaction andServices Inspection Index of these two aspects of the research has important practicalsignificance to improve the safety and quality of care intravenous indwelling Forfurther promote the use of VPA has important application value.This study intendsto carry out a comparative study of the two types of catheter complications, in thesame time we survey the quality of life during chemotherapy, and the servicesatisfaction and service inspection index, which result will of great significance indemonstrate and improve the nursing practice, improve the quality of nurshing service,and provide a reference for the different patients choose to use an effective, safe andcost-effective deep venous vascular access.Objective: To analysis the general condition, the difference of the main clinicalfeatures, the maintenance and complications of the catheter, the quality of life and thecatheter use service satisfaction of the patients with malignant tumors, compare thetwo ways used,,and to provide more scientific and rational basis for clinical catheterapproach selection.Method: From January2012to September2012,100patients with malignanttumors,who had accept radical tumor surgery in the general surgery Center of JilinUniversity, were divided into VPA group with50cases and PICC group with50cases,according to the way different central venous catheter. The self-preparedcomposite questionnaire were used to survey the general clinical information,thequality of life, the catheter use service satisfaction; The Catheter use, maintenanceinformation collection form were used to Collect catheter use and maintenance of thesituation, complication rate, and other related information.EPIDATA was used for dataentry, and SPSS12.0software package was used for statistical analysis.x±sor M (Q)were used for the statistical description of measurement data, and T or rank sum test were used for comparison between groups; Frequency counts and percentages wereused for statistical description of count data, and χ2test were used for comparisonbetween groups.Results: In the composition of the general socio-demographic characteristics andclinical features of VPA group and PICC group,the differences not statisticallysignificant (P>0.05); In the the average time indwelling catheter use and maintenance,the difference was statistically significant (t=3.250,P=0.014);The total incidence ofcomplications in VPA group were lower than in the PICC group, the differences inthe two groups were statistically significant (χ2=6.257, P=0.012). Catheterobstruction and phlebitis,as the single complication, were higher in the PICC Groupthan in the VPA group,and The difference was statistically significant (P=0.025; P=0.012);Comparative analysis of the quality of life score on two groups of patients inthe seven dimensions of physical functioning, role functioning, emotional functioning,social functioning, physical symptoms, economic hardship and the overall healthstatus, the difference was not statistically significant (P>0.05);In the Overallsatisfaction on the quality of health services in the process of catheter use, thedifferences in the two groups were statistically significant (t=4.762, P <0.001).In theseven catheter use phase service experience evaluation index, the VPA group werelower than the PICC group. As In Catheter overall services index, and complaintmanagement applications catheter index, general the catheter index, treatmentinformation index, index, index of the physical environment and discharge andfollow-up index,the difference was also statistically significant (P <0.01).Conclusion: he total complication rate is lower in VPA group than the PICCgroup, with the main complications of catheter obstruction and phlebitis in PICCgroup;The average retention time is longer in VPA group than the PICC group; Thereis no difference in the quality of life in VPA group and PICC group, the overall healthstatus of the patients with malignant tumors is fair. The overall satisfaction andservice experience of VPA group is lower than PICC group,which indicate that thequality of service needs to be improved by hospital in the process of catheter use inVPA group. The service and management of the various stages in the using process ofVPA should be strengthen effectively, to improve the quality of service in the processof catheter use, improve patient satisfaction.