Huijgens P C, Strack van Schijndel R, Kampman I, Ossenkoppele G J, Klomp-Gerringa M, van der Putten E
Department of Hematology, Free University Hospital, Amsterdam, The Netherlands.
Neth J Med. 1991 Apr;38(3-4):153-8.
In patients with hematological malignancies, we prospectively evaluated the use of untunnelled subclavian vein catheters placed either for short term chemotherapy (48 episodes) or for long-term intensive supportive care during pancytopenia (152 episodes). The 200 catheters were placed in 88 different patients. There were 2 placement failures and 2 cases of minor pneumothorax. In 4 episodes ecchymoses and in 1 uncontrollable bleeding from the exit site occurred. The mean time to removal was 25.6 days (range 0-149). There was 1 exit site infection and 26 periods of septicemia, of which 8 were considered catheter associated. All infections responded to appropriate treatment. Irreversible obstruction occurred in 4 and dislodgement in another 4 episodes out of a total number of 11 failures. Patient acceptance was high although repeated placements were frequently undertaken for successive periods of treatment and supportive care. With meticulous sterile techniques of placement and catheter care it seems that untunnelled subclavian vein catheters are reliable and safe in hematooncology.
在血液系统恶性肿瘤患者中，我们前瞻性评估了未带隧道的锁骨下静脉导管的使用情况，这些导管用于短期化疗（48例次）或全血细胞减少期间的长期强化支持治疗（152例次）。200根导管植入了88例不同患者体内。有2次置管失败和2例轻度气胸。4例次出现瘀斑，1例出口部位发生难以控制的出血。导管拔除的平均时间为25.6天（范围0 - 149天）。发生1例出口部位感染和26次败血症，其中8次被认为与导管相关。所有感染经适当治疗后均有反应。在总共11次故障中，4次发生不可逆阻塞，另外4次发生导管移位。尽管在连续的治疗和支持护理期间经常需要重复置管，但患者接受度较高。通过细致的无菌置管技术和导管护理，未带隧道的锁骨下静脉导管在血液肿瘤学中似乎是可靠且安全的。
