Lorenz J M, Funaki B, Van Ha T, Leef J A
Department of Radiology, The University of Chicago Hospitals, 5841 S. Maryland Ave., MC 2026, Chicago, IL 60637, USA.
AJR Am J Roentgenol. 2001 Apr;176(4):991-4. doi: 10.2214/ajr.176.4.1760991.
We evaluated the technical success and complications associated with radiologic placement of implantable chest ports in children for long-term central venous access.
Between May 1, 1996 and January 11, 2000, 29 chest ports were placed in 28 children (15 girls, 13 boys; age range, 2-17 years; mean, 11.7 years). The patient's right internal jugular vein was used for access in 93% (27/29) of the procedures, and a collateral neck vein was used as a conduit to recanalize the central veins in two procedures because of bilateral jugular and subclavian vein occlusion. All procedures were performed in interventional radiology suites. Both real-time sonography and fluoroscopy were used to guide venipuncture and port insertion. Follow-up data were obtained through the clinical examination and electronic review of charts.
Technical success was 100%. Fourteen percent of the catheters were removed prematurely, including one catheter removed 17 days after placement because the patient's blood cultures were positive for Candida albicans. No patients experienced hematoma, symptomatic air embolism, symptomatic central venous thrombosis, catheter malposition, or pneumothorax. The median number of days for catheter use by patients was 280 days (total, 9043 days; range, 17-869 days). The rate of confirmed catheter-related infection was 14% or 0.04 per 100 venous access days. One catheter occluded after 132 days.
In pediatric patients, radiologists can insert implantable chest ports using real-time sonographic and fluoroscopic guidance with high rates of technical success and low rates of complication.
我们评估了儿童可植入式胸部端口经放射学放置以实现长期中心静脉通路的技术成功率及相关并发症。
在1996年5月1日至2000年1月11日期间，28名儿童（15名女孩，13名男孩；年龄范围2至17岁，平均11.7岁）植入了29个胸部端口。93%（27/29）的操作使用患者右侧颈内静脉进行穿刺，有两例操作因双侧颈静脉和锁骨下静脉闭塞，使用颈侧支静脉作为重新开通中心静脉的通道。所有操作均在介入放射科进行。实时超声和荧光透视均用于引导静脉穿刺和端口植入。通过临床检查和电子病历回顾获取随访数据。
技术成功率为100%。14%的导管被过早拔除，其中一根导管在放置17天后因患者血培养白色念珠菌阳性而拔除。无患者发生血肿、有症状的空气栓塞、有症状的中心静脉血栓形成、导管位置异常或气胸。患者使用导管的中位天数为280天（总计9043天；范围17至869天）。确诊的导管相关感染率为14%或每100个静脉通路日0.04例。一根导管在132天后发生堵塞。
在儿科患者中，放射科医生可在实时超声和荧光透视引导下植入可植入式胸部端口，技术成功率高且并发症发生率低。
