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癌症患者使用的长期、带隧道、无袖套中心静脉导管(Vygon):安全性、有效性及并发症

Long-term, tunneled, noncuffed central venous catheter in cancer patients (Vygon): safety, efficacy, and complications.

作者信息

Masci Giovanna, Magagnoli Massimo, Pedicini Vittorio, Poretti Dario, Castagna Luca, Carnaghi Carlo, Morenghi Emanuela, Del Vecchio Antonietta, Finotto Rita, Brambilla Giorgio, Santoro Armando

机构信息

Department of Medical Oncology and Hematology, Istituto Clinico Humanitas, Via Manzoni 56, 20089, Rozzano, Milano, Italy.

出版信息

Support Care Cancer. 2006 Nov;14(11):1141-6. doi: 10.1007/s00520-006-0065-2. Epub 2006 Apr 19.

Abstract

BACKGROUND

Totally implantable or partially cuffed central venous catheters (CVC) are commonly used in cancer patients, but they are often expensive and may produce complications. To minimize costs, we have been using a low-cost, partially tunneled, silicone elastomer catheter with no Dacron cuff or antireflux valve (Vygon) since 2001. This study is a retrospective investigation of our experience using the Vygon catheter as a long-term CVC in patients with malignancy.

MATERIALS AND METHODS

A total of 458 Vygon catheters (Nutricath, Vygon) were percutaneously inserted by an interventional radiologist in 302 cancer patients. The median duration of catheter use was 93 days, mean 164.3 days (range 1-789). Main patient characteristics were as follows: number of male/female patients, 166/136; median age, 51 years; hematological/nonhematological patients, 189/113.

RESULTS

Early complications were pneumothorax in six and hematoma in twelve of 458 implants, respectively. Thirteen out of 302 patients developed a catheter-related thrombosis. One hundred and thirty-five of 458 Vygon catheters required removal because of catheter-related complications: 68 accidental losses, 37 cases of febrile neutropenia suspected to be catheter-related, ten catheter dislodgements, ten catheter malfunctions, four local infections, three thromboses, two catheter ruptures, and one allergic reaction.

CONCLUSION

Vygon catheters do not seem to induce more early and late complications as compared with other more expensive devices, except for disadvantage of the high incidence rate of accidental losses.

摘要

背景

完全植入式或部分带袖套的中心静脉导管(CVC)常用于癌症患者,但它们往往价格昂贵且可能引发并发症。为了将成本降至最低,自2001年以来,我们一直在使用一种低成本、部分经隧道植入的硅橡胶弹性体导管,该导管没有涤纶袖套或抗反流阀(Vygon)。本研究是对我们使用Vygon导管作为恶性肿瘤患者长期CVC的经验进行的回顾性调查。

材料与方法

一名介入放射科医生为302例癌症患者经皮插入了总共458根Vygon导管(Nutricath,Vygon)。导管使用的中位持续时间为93天,平均164.3天(范围1 - 789天)。主要患者特征如下:男性/女性患者数量为166/136;中位年龄为51岁;血液系统/非血液系统患者为189/113。

结果

早期并发症分别为458例植入中有6例发生气胸和12例发生血肿。302例患者中有13例发生导管相关血栓形成。458根Vygon导管中有135根因导管相关并发症需要拔除:68例意外丢失,37例疑似与导管相关的发热性中性粒细胞减少,10例导管移位,10例导管故障,4例局部感染,3例血栓形成,2例导管破裂,以及1例过敏反应。

结论

与其他更昂贵的装置相比,Vygon导管似乎不会引发更多的早期和晚期并发症,除了意外丢失发生率高这一缺点。

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