Objective

This study aimed to analyze the application value of intracavitary electrocardiogram (ECG) classification in peripherally inserted central catheter (PICC) tip localization in patients with cancer.

Methods

Using a self-control study method, 325 patients with cancer underwent intracavitary ECGs to position the tip of a PICC catheter. The P wave, QRS wave amplitude, and waveform changes of each intracavitary ECG were recorded. Chest X-ray examination was performed after the catheterization to compare the results of different intracavity ECG maps with the results of the chest X-ray.

Results

The intracavitary ECG positioning maps of the 325 patients were divided into four categories: (1) increased P wave (293 cases), accounting for 90.15% (293/325) of all cases; compared with the positioning results of the chest X-rays, the placement rate was 98.98% (290/293); (2) negative deepening of the P wave (1 case), accounting for 0.31% (1/325) of all cases and with a placement rate of 100% (1/1); (3) no change in P wave (19 cases), accounting for 5.85% (19/325) of all cases and with a placement rate of 42.11% (8/19); (4) atrial fibrillation/atrial flutter (12 cases), accounting for 3.69% (12/325) of all cases and with a placement rate of 58.33% (7/12). The four types of intracavitary ECG positioning maps had statistically significant differences (χ² = 133.924, P = 0.000).

Conclusion

There are four types of intracavitary ECG localization maps: increased P wave, negative deepening of the P wave, no change in P wave, and atrial fibrillation/atrial flutter. The increased P wave pattern had the highest occurrence probability and high positioning accuracy. It therefore has strong clinical application value for PICC tip localization in patients with cancer.

中文翻译：

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腔内心电图分类在癌症患者外周中心导管定位中的应用

客观的

本研究旨在分析腔内心电图（ECG）分类在癌症患者外周插入中心导管（PICC）尖端定位中的应用价值。

方法

使用自我对照研究方法，325 名癌症患者接受了腔内心电图来定位 PICC 导管的尖端。记录每个腔内心电图的P波、QRS波幅值和波形变化。置管后进行胸部X线检查，将不同腔内心电图的结果与胸部X线结果进行比较。

结果

将325例患者的腔内心电图定位图分为四类：（1）P波增高（293例），占全部病例的90.15%（293/325）；与胸片定位结果相比，定位率为98.98%（290/293）；（2）P波负性加深（1例），占全部病例的0.31%（1/325），放置率100%（1/1）；（3）P波无变化（19例），占全部病例的5.85%（19/325），放置率为42.11%（8/19）；(4)心房颤动/心房扑动(12例)，占全部病例的3.69%(12/325)，安置率为58.33%(7/12)。四种腔内心电图定位图差异有统计学意义（χ ²  = 133.924，P  = 0.000）。

结论

腔内心电图定位图有四种：P波增高、P波负性加深、P波无变化、心房颤动/心房扑动。增加的P波型出现概率最高，定位精度高。因此对于肿瘤患者的PICC针尖定位具有很强的临床应用价值。