Lee M K S, Mossop P J, Vrazas J I
Department of Interventional Radiology, St Vincent's Hospital, Melbourne, Victoria, Australia.
Australas Radiol. 2007 Feb;51(1):35-41. doi: 10.1111/j.1440-1673.2006.01656.x.
The aim of this retrospective study was to analyse the outcomes of central venous catheter (CVC) placement carried out by an interventional radiology unit. A review of our hospital records identified 331 consecutive patients who underwent insertion of a tunnelled or non-tunnelled CVC between January 2000 and December 2004. Key outcome measures included the technical success rate of CVC insertion and the percentage of immediate (<24 h), early (24 h-30 days) and late (>30 days) complications. A total of 462 CVCs were placed under radiological guidance, with an overall success rate of 98.9%. Immediate complications included one pneumothorax, which was diagnosed 7 days after subclavian CVC insertion, and eight episodes of significant haematoma or bleeding within 24 h of CVC insertion. No cases were complicated by arterial puncture or air embolus. Catheter-related sepsis occurred in 2% of non-tunnelled CVC and 8.9% of tunnelled CVC. The overall incidence of catheter-related sepsis was 0.17 per 100 catheter days. As the demand for chemotherapy and haemodialysis grows with our ageing population, interventional radiology suites are well placed to provide a safe and reliable service for the placement of central venous access devices.
这项回顾性研究的目的是分析介入放射科进行中心静脉导管(CVC)置入的结果。回顾我院记录发现,2000年1月至2004年12月期间,连续有331例患者接受了隧道式或非隧道式CVC置入。主要结局指标包括CVC置入的技术成功率以及即刻(<24小时)、早期(24小时至30天)和晚期(>30天)并发症的发生率。在放射学引导下共置入了462根CVC,总体成功率为98.9%。即刻并发症包括1例气胸,在锁骨下CVC置入后7天被诊断出,以及8例在CVC置入后24小时内出现的严重血肿或出血。无动脉穿刺或空气栓塞并发症病例。非隧道式CVC的导管相关脓毒症发生率为2%,隧道式CVC为8.9%。导管相关脓毒症的总体发生率为每100导管日0.17例。随着我们老龄化人口对化疗和血液透析需求的增加,介入放射科很适合为中心静脉通路装置的置入提供安全可靠的服务。