Kefeli U, Dane F, Yumuk P F, Karamanoglu A, Iyikesici S, Basaran G, Turhal N S
Department of Internal Medicine, Marmara University Medical School, Istanbul, Turkey.
Eur J Cancer Care (Engl). 2009 Mar;18(2):191-4. doi: 10.1111/j.1365-2354.2008.00973.x.
The long-term use of subcutaneous implanted ports for chemotherapy in cancer patients has been associated with the occurrence of thrombosis and infection. In this study, we compared the safety and efficacy of administration of 1000 U of heparin flushes in prolonged interval (every 6 weeks) with standard dose and schedule (500 U every 4 weeks) for port-related infections and thrombosis during periods of non-use. Data were collected retrospectively from patients treated for various cancer types (matched as 2:1 for age, gender, stage of the disease). Patients who had diseases that could cause thrombosis or bleeding in their past medical history, or were taking oral anticoagulants, or had contraindications for heparin usage were excluded. After completing their chemotherapy, 59 patients received prolonged interval, while 30 patients received standard schedule. All patients were followed for at least 1 year. No clinically documented port-related infection or thrombosis has been found in both groups. Also, none of the devices was removed during this time. Prophylactic flushing of central venous ports with 1000 U of heparin in every 6 weeks might be a safe, easy, cheaper, comfortable and effective alternative to standard dose and schedule for preventing thrombosis and infections.
癌症患者长期使用皮下植入式端口进行化疗与血栓形成和感染的发生有关。在本研究中,我们比较了在不使用期间,每6周延长间隔给予1000 U肝素封管与标准剂量和方案(每4周500 U)预防端口相关感染和血栓形成的安全性和有效性。回顾性收集了接受各种癌症类型治疗的患者数据(按年龄、性别、疾病分期2:1匹配)。排除既往病史中有可导致血栓形成或出血的疾病、正在服用口服抗凝剂或有肝素使用禁忌证的患者。完成化疗后,59例患者接受延长间隔封管,30例患者接受标准方案封管。所有患者均随访至少1年。两组均未发现临床记录的与端口相关的感染或血栓形成。此外,在此期间没有移除任何装置。每6周用1000 U肝素预防性封管中心静脉端口可能是一种安全、简便、便宜、舒适且有效的替代标准剂量和方案的方法,用于预防血栓形成和感染。