Wu Jiunn-Ren, Hsu Jong-Hau, Chang Tai-Tsung, Dai Zen-Kong, Lu Chu-Chong, Wu Ding-Kuo
Department of Pediatrics, Kaohsiung Medical University Hospital, Taiwan.
Jpn Heart J. 2002 May;43(3):295-300. doi: 10.1536/jhj.43.295.
A total of 110 central venous access procedures using Port-A catheters were performed in our center for pediatric patients with oncologic or hematologic diseases over a period of 6 years from November 1994 to June 2000. Spontaneous dislodgement of the outlet catheters was noted in two cases. Both dislodged catheters were located in the left pulmonary artery and were successfully retrieved via the right femoral vein by nonsurgical transvenous snares. Awareness of the possibility of spontaneous catheter dislodgement and embolization of Port-A catheters is important as prompt retrieval will prevent further serious complications. When the procedure is performed by an open surgical method, to reduce the possibility of spontaneous catheter dislodgement, the use of a guidewire is recommended while a Port-A catheter is being inserted into the subclavian vein.
1994年11月至2000年6月的6年间,我们中心共为患有肿瘤或血液疾病的儿科患者进行了110例使用植入式静脉输液港导管的中心静脉置管操作。发现有2例出口导管发生自发性移位。两根移位的导管均位于左肺动脉,并通过非手术经静脉圈套器经右股静脉成功取出。认识到植入式静脉输液港导管发生自发性移位和栓塞的可能性很重要,因为及时取出可预防进一步的严重并发症。当采用开放手术方法进行该操作时,为降低导管自发性移位的可能性,建议在将植入式静脉输液港导管插入锁骨下静脉时使用导丝。