Jones Sarah A, Giacomantonio Michael
Division of Pediatric Surgery, Dalhousie University, IWK Health Center, Halifax, Nova Scotia, Canada.
J Pediatr Surg. 2003 Apr;38(4):594-6. doi: 10.1053/jpsu.2003.50129.
There are many reports on the complications that occur at the time of insertion and during the life of central venous indwelling catheters. However, there is no literature that describes the complications that occur at the time of removal of these lines.
A retrospective review of 136 central line (Broviacs [B], Port-A- Caths [PC] and Hickmans [HC]) removals during the last 5 years was undertaken.
A total of 97% were removed after completion of chemotherapy, and 3% because of sepsis or malfunction. Three PC lines broke at the time of removal resulting in a length of line remaining in the central venous system (the superior vena cava, innominate vein, and bracheo-cephalic subclavian junction). Two lines were inserted by a cut-down technique into the external jugular and one line by the percutaneous technique into the subclavian vein. At follow-up, none of the residual lines were associated with thrombus formation, and none showed any evidence of migration.
This review identifies a specific problem that can occur with central line removal. Both the long-term affects of residual catheter within the central venous system and the need to remove the foreign body have yet to be addressed.
关于中心静脉留置导管插入时及使用期间出现的并发症已有很多报道。然而，尚无文献描述这些导管拔除时出现的并发症。
对过去5年中136例中心静脉导管（Broviac导管[B]、植入式静脉输液港[PC]和Hickman导管[HC]）拔除情况进行回顾性分析。
97%的导管在化疗结束后拔除，3%因败血症或功能故障拔除。3根植入式静脉输液港导管在拔除时断裂，导致一段导管残留在中心静脉系统（上腔静脉、无名静脉和头臂-锁骨下静脉交界处）。2根导管通过切开法插入颈外静脉，1根导管通过经皮技术插入锁骨下静脉。随访时，残留导管均未形成血栓，也无移位迹象。
本研究明确了中心静脉导管拔除时可能出现的一个特殊问题。中心静脉系统内残留导管的长期影响以及取出异物的必要性仍有待探讨。
