目的 探讨优化光源环境联合血管显像仪对核医学科肿瘤患者静脉穿刺效果的影响，为核医学特殊场景下的穿刺操作提供循证依据。 方法 前瞻性纳入2025年1—12月在安阳市肿瘤医院核医学科行全身骨显像的240例肿瘤患者，采用随机数字表法将患者分为4组，每组60例。A组：正常光源（300 ~ 500 lx，色温4 000 K）下直接穿刺；B组：优化光源（650 ~ 750 lx，色温5 000 ~ 5 500 K，光源与静脉呈30° ~ 45°）下直接穿刺；C组：正常光源+血管显像仪引导下穿刺；D组：优化光源+血管显像仪引导下穿刺。比较4组的一次性穿刺成功率、穿刺时间、VAS疼痛评分、操作者满意度及并发症发生率。 结果 D组一次性穿刺成功率最高（98.3%），显著高于A组（83.3%，P = 0.004）和B组（88.3%，P = 0.028），与C组（96.7%）比较差异无统计学意义（P = 0.559）。D组穿刺时间最短（中位数78.50 s），显著短于其他三组（均P < 0.001）。D组VAS疼痛评分最低（2.00 ± 0.80），显著低于A、B、C组（P < 0.05）。D组操作者满意度最高（4.37 ± 0.82），显著高于A、B组（P < 0.001）及C组（P = 0.030）。总并发症发生率D组最低（5.0%），显著低于A组（21.7%，P=0.007）和B组（18.3%，P = 0.023），与C组（10.0%）差异无统计学意义（P = 0.298）。 结论 优化光源环境联合血管显像仪可显著提高核医学科肿瘤患者静脉穿刺的一次性成功率，缩短操作时间，减轻患者疼痛，降低总并发症发生率，提升操作者满意度。尤其适用于因药物衰变限制、需确保单次穿刺成功的核医学操作场景。

Objective To evaluate the efficacy of an optimized lighting environment combined with a vein visualization device for intravenous puncture in oncology patients undergoing nuclear medicine procedures， thereby providing evidence-based support for venipuncture practices in this specific clinical setting. Methods A prospective randomized controlled study was conducted involving 240 oncology patients undergoing whole-body bone scintigraphy at the Department of Nuclear Medicine， Anyang Tumor Hospital， between January and December 2025. Patients were randomized into four groups （n = 60 per group） using a random number table： Group A underwent conventional puncture under standard lighting （300 - 500 lx， 4 000 K）； Group B underwent conventional puncture under optimized lighting （650 - 750 lx， 5 000 - 75 500 K， with the light source positioned at a 30° - 45° angle to the vein）； Group C underwent vein visualization device-guided puncture under standard lighting； and Group D underwent vein visualization device-guided puncture under optimized lighting. The outcomes compared among the four groups included the first-pass success rate， puncture duration， Visual Analogue Scale （VAS） pain score， operator satisfaction， and complication rates. Results Group D achieved the highest first-pass success rate （98.3%）， which was significantly higher than that of Group A （83.3%， P = 0.004） and Group B （88.3%， P = 0.028）， with no significant difference compared to Group C （96.7%， P = 0.559）. Group D exhibited the shortest puncture duration （median： 78.50 s）， which was significantly shorter than that of the other three groups （all P < 0.001）. The VAS pain score was lowest in Group D （2.00 ± 0.80）， significantly lower than those in Groups A， B， and C （all P < 0.05）. Operator satisfaction was highest in Group D （4.37 ± 0.82）， significantly exceeding that in Groups A and B （both P < 0.001） and Group C （P = 0.030）. Furthermore， Group D demonstrated the lowest overall complication rate （5.0%）， significantly lower than that of Group A （21.7%， P = 0.007） and Group B （18.3%， P = 0.023）， but comparable to Group C （10.0%， P = 0.298）. Conclusion The combination of an optimized lighting environment and a vein visualization device significantly improves the first-pass success rate， shortens puncture duration， alleviates patient pain， reduces the overall complication rate， and enhances operator satisfaction during intravenous puncture in oncology patients undergoing nuclear medicine procedures. This combined strategy is particularly advantageous in nuclear medicine， where the short half-life of radiopharmaceuticals necessitates a successful first-pass puncture to minimize radioactive decay and ensure optimal imaging quality.