Schrøder M, Pedersen I R, Rasmussen R B
Kirurgisk afdeling, Finseninstitutet, Rigshospitalet, København.
Ugeskr Laeger. 1991 Sep 2;153(36):2491-4.
Permanent central venous catheters play an important role in the treatment of patients with malignancies. Two systems are available, Hickman-Broviac Catheters (HB) and Port-a-Cath (PAC), the latter is fully implantable. Since 1982, the systems have been used in the Finsen Institute. In the period 01.01.1984 to 31.03.1988 a total of 232 HB and 52 PAC were inserted in 245 patients with solid malignant tumours with one exception. All the catheters were inserted with the venous cut-down technique and at the end of the period mainly in local analgesia. The total indwelling time was 36,859 days, mean 99 days (1-616 days) for HB and 92 days (8-519 days) for PAC. Seventeen catheters remained in place for more than 365 days. A total of 114 complications concerning 88 catheters were registered. The most serious complications were sepsis and thrombosis. The frequency of sepsis was low, 0.06 (HB) and 0.01 (PAC) per 100 catheter-days. The corresponding frequency of thrombosis was 0.03/100 catheter-days for both systems. Sixty-one HB and five PAC had to be removed because of complications. In general, the complication rate was lower for the PAC method. In addition, the nursing care was reduced to a minimum. The surgical cut-down method is preferable, as catheter implantation is possible even in patients with disorders of the coagulation system.
永久性中心静脉导管在恶性肿瘤患者的治疗中发挥着重要作用。有两种系统可供选择，即希克曼-布罗维亚克导管（HB）和植入式静脉输液港（PAC），后者是完全可植入的。自1982年以来，这些系统一直在芬森研究所使用。在1984年1月1日至1988年3月31日期间，245例实体恶性肿瘤患者共插入了232根HB导管和52根PAC导管，只有1例例外。所有导管均采用静脉切开技术插入，在该时期结束时主要采用局部镇痛。总留置时间为36859天，HB导管平均99天（1 - 616天），PAC导管平均92天（8 - 519天）。17根导管留置时间超过365天。共记录了涉及88根导管的114例并发症。最严重的并发症是败血症和血栓形成。败血症的发生率较低，HB导管每100导管日为0.06，PAC导管每100导管日为0.01。两种系统血栓形成的相应发生率均为0.03/100导管日。由于并发症，61根HB导管和5根PAC导管不得不被拔除。总体而言，PAC方法的并发症发生率较低。此外，护理工作减少到了最低限度。手术切开方法更可取，因为即使是凝血系统有障碍的患者也可以进行导管植入。
