Different conductive media for intracavitary electrocardiogram-guided arm port implantation among breast cancer patients: a randomized controlled trial

doi:10.3877/cma.j.issn.1674-0785.2023.07.001

Abstract

Abstract:

Objective

To investigate the effect of using normal saline and guide wire as conductive media for intracavitary electrocardiogram-guided arm port implantation among breast cancer patients.

Methods

A total of 184 breast cancer patients who chose arm port as chemotherapy access were recruited at the Department of Thyroid Breast Surgery of Peking University First Hospital, and they were randomly divided into a guide wire electrode group and a liquid electrode group. The accuracy of catheter tip position, the occurrence rate of characteristic P wave, P wave height, QRS wave height, stability of electrocardiogram, nurse satisfaction, and length of operation were compared between two groups.

Results

The accuracy of catheter tip position was 95.6% in the liquid electrode group, while it was 98.9% in the guide wire electrode group, without significant difference between the two groups (χ²=0.209, P=0.177). No significant difference was found in the occurrence rate of characteristic P wave, P wave height, QRS wave height, stability of electrocardiogram, nurse satisfaction, or length of operation between the two groups (P＞0.05).

Conclusion

It is recommended to use intracavitary electrocardiogram to guide tip position in arm port implantation. Both guide wire electrode and liquid electrode can lead to a success of the surgery. The intravenous specialist nurses can choose either of them according to their own habit and medium availability.

Key words: Breast cancer, Arm port, Tip position, Intracavitary electrocardiogram

Fei Liu, Yingxin Wang, Xing Ma, Ling Xin, Yuanjia Cheng, Qian Liu, Yue Wang, Junjun Zhang. Different conductive media for intracavitary electrocardiogram-guided arm port implantation among breast cancer patients: a randomized controlled trial[J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(07): 760-764.

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Figures/Tables 2

临床资料	生理盐水组（91例）	导丝组（93例）	t/χ²值	P值
年龄（岁， $x ¯$ ±s）	51.51±9.95	53.53±9.99	-1.243	0.216
身高（cm， $x ¯$ ±s）	160.52±4.55	161.88±5.15	-1.721	0.087
体重（kg， $x ¯$ ±s）	64.05±10.07	62.37±9.35	1.063	0.290
BMI（kg/m²， $x ¯$ ±s）	24.83±3.58	23.80±3.35	1.834	0.069
臂围（cm， $x ¯$ ±s）	27.56±4.69	27.48±2.94	0.115	0.908
体表测量长度（cm， $x ¯$ ±s）	36.12±2.91	35.76±3.12	0.815	0.416
植入导管长度（cm， $x ¯$ ±s）	36.86±3.01	36.76±3.37	0.222	0.825
穿刺静脉内径（mm， $x ¯$ ±s）	5.09±0.81	5.00±0.71	0.779	0.431
植入手臂［例（%）］			0.339	0.560
左臂	45（49.5）	42（45.2）
右臂	46（50.5）	51（54.8）
植入静脉［例（%）］			0.312	0.577
贵要静脉	86（94.5）	86（92.5）
其他	5（5.5）	7（7.5）

临床资料	生理盐水组（91例）	导丝组（93例）	t/χ²值	P值
年龄（岁， $x ¯$ ±s）	51.51±9.95	53.53±9.99	-1.243	0.216
身高（cm， $x ¯$ ±s）	160.52±4.55	161.88±5.15	-1.721	0.087
体重（kg， $x ¯$ ±s）	64.05±10.07	62.37±9.35	1.063	0.290
BMI（kg/m²， $x ¯$ ±s）	24.83±3.58	23.80±3.35	1.834	0.069
臂围（cm， $x ¯$ ±s）	27.56±4.69	27.48±2.94	0.115	0.908
体表测量长度（cm， $x ¯$ ±s）	36.12±2.91	35.76±3.12	0.815	0.416
植入导管长度（cm， $x ¯$ ±s）	36.86±3.01	36.76±3.37	0.222	0.825
穿刺静脉内径（mm， $x ¯$ ±s）	5.09±0.81	5.00±0.71	0.779	0.431
植入手臂［例（%）］			0.339	0.560
左臂	45（49.5）	42（45.2）
右臂	46（50.5）	51（54.8）
植入静脉［例（%）］			0.312	0.577
贵要静脉	86（94.5）	86（92.5）
其他	5（5.5）	7（7.5）

项目	生理盐水组（91例）	导丝组（93例）	t/Z值	P值
P波高度（mm， $x ¯$ ±s）	7.76±4.24	7.74±4.30	0.031	0.975
QRS波高度（mm， $x ¯$ ±s）	14.09±7.49	14.28±8.07	-0.161	0.872
心电图稳定性评分（ $x ¯$ ±s）	4.74±0.53	4.77±0.57	-0.331	0.741
操作满意度评分（ $x ¯$ ±s）	4.60±0.65	4.62±0.67	-0.198	0.884
置管用时［s，M（Q₂₅，Q₇₅）］	383（309，506）	407（326，612）	-0.510	0.131

项目	生理盐水组（91例）	导丝组（93例）	t/Z值	P值
P波高度（mm， $x ¯$ ±s）	7.76±4.24	7.74±4.30	0.031	0.975
QRS波高度（mm， $x ¯$ ±s）	14.09±7.49	14.28±8.07	-0.161	0.872
心电图稳定性评分（ $x ¯$ ±s）	4.74±0.53	4.77±0.57	-0.331	0.741
操作满意度评分（ $x ¯$ ±s）	4.60±0.65	4.62±0.67	-0.198	0.884
置管用时［s，M（Q₂₅，Q₇₅）］	383（309，506）	407（326，612）	-0.510	0.131

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