van der Pijl H, Frissen P H
Department of Internal Medicine (AIDS Unit), University of Amsterdam, The Netherlands.
AIDS. 1992 Jul;6(7):709-13. doi: 10.1097/00002030-199207000-00014.
To determine the complication rate of a totally implantable central venous access device [Port-A-Cath (PAC)] in AIDS patients, used mainly for home infusion therapy.
A retrospective study.
The study was performed at the AIDS Unit of the Department of Internal Medicine, Academic Medical Centre, University of Amsterdam, The Netherlands.
PATIENTS, PARTICIPANTS: Forty-seven consecutive AIDS patients who had a PAC device implanted to receive either drug maintenance therapy (42 patients) or total parenteral nutrition (TPN; five patients).
Fifty-one devices were implanted between June 1987 and October 1990. Mean puncture frequency was five times per week. The total number of catheter days was 9069. The total complication rate was 0.43 per 100 catheter days. Complications occurred in 17 (36%) patients: three implantation-related bleedings (0.03 per 100 catheter days), three puncture-related bleedings (0.03 per 100), two infections (0.17 per 100), seven occlusions (0.08 per 100), four flow problems (0.04 per 100) and one central vein thrombosis (0.011 per 100). Imminent skin necrosis at puncture site occurred in one case (0.01 per 100) and drug extravasation in two cases (0.02 per 100). Eight devices (17%) had to be removed. Primary septicaemias were resolved using antibiotics in three out of six patients in whom they occurred. Occlusions were almost exclusively caused by TPN.
A totally implantable venous access device appears to be safe and convenient in (home) infusion therapy in AIDS patients, without risk of additional infection.
确定主要用于家庭输液治疗的完全植入式中心静脉通路装置[Port - A - Cath（PAC）]在艾滋病患者中的并发症发生率。
一项回顾性研究。
该研究在荷兰阿姆斯特丹大学学术医学中心内科艾滋病科进行。
患者、参与者：47例连续的艾滋病患者，他们植入了PAC装置以接受药物维持治疗（42例患者）或全胃肠外营养（TPN；5例患者）。
1987年6月至1990年10月期间共植入了51个装置。平均穿刺频率为每周5次。导管使用天数总计9069天。总并发症发生率为每100导管日0.43。17例（36%）患者发生并发症：3例与植入相关的出血（每100导管日0.03），3例与穿刺相关的出血（每100导管日0.03），2例感染（每100导管日0.17），7例堵塞（每100导管日0.08），4例血流问题（每100导管日0.04）和1例中心静脉血栓形成（每100导管日0.011）。1例患者穿刺部位出现即将发生皮肤坏死（每100导管日0.01），2例患者发生药物外渗（每100导管日0.02）。8个装置（17%）不得不被移除。6例发生原发性败血症的患者中有3例使用抗生素后得到缓解。堵塞几乎完全由TPN引起。
完全植入式静脉通路装置在艾滋病患者的（家庭）输液治疗中似乎是安全且方便的，没有额外感染风险。
