本研究旨在评估皮下隧道技术对经外周插入中央导管（PICC）置入的影响。我们于2021年8月至12月，随机选取了694名需要PICC置入的患者，将其分为隧道式PICC组（实验组）和非隧道式PICC组（对照组）。主要观察指标为并发症的累计发生率。次要观察指标包括出血量、导管插入时间、自主报告的疼痛评分和单次穿刺成功率。随访6个月后，与对照组相比，隧道式PICC显著降低了并发症的发生频率，尤其是感染（3.0% vs. 7.1%，p = .021）和导管相关血栓形成（3.3% vs. 8.3%，p = .008）。尽管增加了约0.5 ml的出血量和3.5分钟的时间，但这个随机多中心研究支持了皮下隧道技术在减少PICC相关并发症、提高患者舒适度方面的疗效，并鼓励在PICC置入中使用皮下隧道技术。

This study sought to evaluate the impact of the subcutaneous tunneling technique on peripherally inserted central catheter (PICC) placement. We randomized 694 patients who needed PICC placement to either the tunneled PICCs (experimental group) or the non-tunneled PICCs (control group) from August to December 2021. The cumulative frequency of complications was assessed as the primary outcome. Secondary outcomes comprised the amount of bleeding, catheter insertion time, self-reported pain score, and one-puncture success rate. After 6 months of follow-up, the tunneled PICCs significantly decreased the frequency of total complications, especially in infection (3.0% vs. 7.1%, p = .021) and catheter-related thrombosis (3.3% vs. 8.3%, p = .008), although approximately 0.5 ml bleeding and 3.5 min time were increased. This randomized multicenter study supports the efficacy of subcutaneous tunneling technology in reducing PICC-related complications, enhancing patient comfort, and encouraging using subcutaneous tunneling technology for PICC placement.