Effect of comprehensive intervention on PICC-associated phlebitis in patients with breast cancer

Abstract

Objective To evaluate the preventive effect of catheters preconditioning and functional exercise on peripherally inserted central venous catheters (PICC)-associated phlebitis in patients with breast cancer.Methods Forty-six patients with breast cancer subjected to PICC were chosen and randomly divided into the control group (n =22) and the intervention group (n =24).The catheters in control group were dipped into 100 ml normal saline for 3 minutes,while the catheters in intervention group were dipped into 100 ml normal saline which contained 5 mg dexamethasone and 2 ml lidocaine for 3 minutes before PICC.Patients in both groups were inserted PICC by standard procedure.After successful insertion,the control group received regular nursing,and the intervention group was asked to perform functional exercise by using pinch meter.The incidence,occurring time and severity of phlebitis as well as other complications were compared between the two groups.Results The incidence of phlebitis was 8.3％ (2/24) in the intervention group,and lower than 27.3％ (6/22) in the control group,and the difference was statistically significant (x2 =4.217,P =0.031).The difference in the severity of phlebitis between the two groups was statistically significant (Z =-1.968,P =0.049).The occurring time of phlebitis was (92.0 ± 26.5) h in the intervention group,and longer than (50.4 ± 23.9) h in the control group,and the difference was statistically significant (t =2.863,P ＜ 0.05).The incidence of arm swelling was 4.2％ (1/24) in the intervention group,and lower than 22.7％ (5/22) in the control group,the difference was statistically significant (P ＜ 0.05),and the incidences of other complications including bleeding and so on were not different in the two groups (P ＞ 0.05) during 30 days.Conclusions Dipping the catheters into dexamethasone solution before insertion and performing functional exercise after insertion can reduce the incidence and severity degree of PICC-associated phlebitis. Key words: Breast cancer; Peripherally inserted central venous catheters ; Phlebitis; Functional exercise ; Catheters preconditioning