With changes in lifestyle and an increase in bad health habits, cancer has become a noncommunicable and frequently occurring disease that poses a serious threat to human life. Cancer is associated with high rates of morbidity and mortality worldwide. As a major negative life event, advanced malignancies lead to strong mood swings in most patients. Furthermore, various internal and external factors can have a huge impact on patients’ physical and mental health and put them in a stressful situation, causing a series of psychological stress responses. To explore the degree of fear of disease progression in patients with advanced cancer and the usefulness of dignity therapy. Overall, 120 patients with advanced malignant tumors admitted to Shijiazhuang No. 1 hospital between January 2019 and January 2020 were enrolled. The selected patients were divided into the test and control groups (60 people per group) using a random number table. All patients received basic treatment. Patients in the trial group also received dignity therapy. The intervention period was 4 weeks. Simplified scales were used for assessing disease progression (FoP-Q-SF) and quality of life (QLQ-C30) before and after the intervention, and the scores were compared between the groups. After the intervention, the degree of fear in the experimental group was lower than that of the control group. Cognitive function, emotional function, and the scores of the overall health status of the experimental group were higher than those of the control group. Additionally, the scores of fatigue, insomnia, loss of appetite, and diarrhea in the experimental group were lower than those of the control group ( P < 0.05). The social support level scale scores, depression scores, hospital anxiety and depression scale scores, and patient dignity inventory scores of the experimental group were lower than those of the control group ( P < 0.05). Patients with advanced malignant tumors have fear, anxiety, and depression related to disease progression. Dignity therapy is useful for improving the patients’ quality of life, increasing dignity, and enhancing social support.
ObjectiveTo explore the clinical significance of intracavitary electrocardiogram positioning technology in preventing catheter ectopic position during peripherally inserted central catheter (PICC) catheterization in children with tumors.MethodsA retrospective analysis of the clinical data of 62 children who required PICC catheterization was performed. The intracavitary electrocardiogram (ECG) positioning technology was used during the tube placement of the child patients. After the tube was successfully placed, the chest radiograph was taken. The ECG positioning result was compared with the chest radiograph positioning result after the tube was inserted, and the sensitivity and specificity of the ECG positioning were calculated.ResultsThe intracavitary electrocardiogram results of 62 children with PICC catheters showed that 56 cases (90.32%) had characteristic P waves, and six cases (9.68%) had no characteristic P waves. The chest radiographs of 56 children with characteristic P wave showed that 33 cases (58.93%) of the catheter tip position was appropriate, 22 cases (39.29%) of the catheter tip was too deep, and 1 case was in a non‐superior vena cava; six cases of chest radiographs of children with no characteristic P wave showed: one case was too deep at T8 level, one case was too shallow at T4 level, four cases were at non‐superior vena cava, one case was contralateral internal jugular vein, two cases in the contralateral brachiocephalic vein, and one case was the contralateral subclavian vein.ConclusionIntracavitary ECG positioning assisted catheter placement in infants can effectively improve the accuracy of catheter tip position.
Objective To observe the changes of F waves on electrocardiograms (ECGs) in patients with persistent atrial fibrillation during the insertion of a peripherally inserted central catheter (PICC), and to analyze the application effect of the ECG method (through F wave changes) for guiding PICC tip positioning. Methods Seventy‐two patients who met the inclusion criteria and needed a PICC catheter were selected as the research subjects. We observed waveforms in the ECGs when the tip of the catheter reached a predetermined position. The chest X‐ray results were used as the gold standard to calculate the sensitivity and specificity, and judge the safety and accuracy of ECG‐guided PICC tip positioning in patients with atrial fibrillation. Results Of the 72 patients, there was no significant difference between the ECG method and chest X‐ray results (χ2 = 0.2, p > 0.05). Sixty‐one patients had F wave changes on ECG and 10 had no obvious changes (X‐ray results confirmed that five patients had a tip position that was too shallow, two had ectopic tip positions, and three were located in the correct place). The sensitivity of the method was 95.7% and the specificity was 80%. Conclusion As the ECG baselines of patients with persistent atrial fibrillation were difficult to judge and the F wave was irregular, we found that the F wave was significantly higher than before catheter insertion and fell back while withdrawing the catheter, so the catheter should be fed until the F wave significantly increased as the correct position of the catheter tip.
BACKGROUND: Peripherally inserted central catheter (PICC) is widely used in chemotherapy of children with malignant tumors because of its safe operation and long indwelling time. OBJECTIVE: To investigate the effect of intracavitary electroencephalogram (CEEG) localization technique on the success rate and complications of PICC in infants. METHODS: A total of 180 children with PICC catheterization and maintenance at Shijiazhuang First Hospital from January 2017 to January 2020 were selected and divided into control group (n= 90 cases) and observation group (n= 90 cases). The control group observed the tip position of the fixed catheter through X-ray film and adjusted the catheter until its tip was located in the superior vena cava. The observation group used intracavitary electrocardiogram positioning technology. Comparison of the effects of two groups on the success rate and complications of PICC puncture in infants and young children. RESULTS: The success rate of one puncture in the observation group was significantly higher than that in the control group (P< 0.05). Within one month of catheterization, 13 cases had complications, with an incidence rate of 16.00% lower than the control group’s 34.00% (27/80) (P< 0.05). The screening test results showed that the specificity, sensitivity, Youden index, accuracy, kappa coefficient, positive and negative predictive value were 88.89%, 97.56%, 0.86, 96.00%, 0.86, 0.86, respectively. The measured values were 97.56% and 88.89% respectively, and the cost and time of localization were lower than those of X-ray. CONCLUSION: The technique of intracavitary electrogram can be more accurate for infants to place the tip of central venous catheter through peripheral vein, which can effectively improve the success rate of one puncture with low cost, and has high reliability, accuracy and practicability, which is safe and effective.
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