Department of Internal Medicine, University of Maastricht, The Netherlands.
Thromb Res. 2010 Apr;125(4):318-21. doi: 10.1016/j.thromres.2009.06.008. Epub 2009 Jul 28.
Thrombosis and infections are well known complications of central venous catheters and totally implanted access ports. These complications lead to increased costs due to prolonged hospitalisation, increased antibiotics use and need for replacement. The objectives of the study were to document the occurrence of catheter related thrombosis and infections in patients with central venous catheters and totally implanted chest ports in cancer patients and to investigate whether factor V Leiden is a risk factor for catheter related thrombosis.
Between February 2002 and November 2004, 43 patients with central venous catheter or totally implanted access port were followed up to document the occurrence of catheter related thrombosis and infections. Patients received chemotherapy either for haematological malignancy or for solid tumours. Factor V Leiden (R506Q) was determined by restriction fragment length polymorphism analysis. Follow-up period ended in April 2007.
Catheter related thrombosis occurred in 4 patients (4/43; 9.3%) with a totally implanted access port. None of the 3 patients with factor V Leiden had catheter related infection or thrombosis. Catheter related infections occurred in 15 patients: 10 patients (23.3%; 10/43) with central venous catheter and 5 patients (11.6%; 5/43) with totally implanted access ports. Time to infection was 32.5 days in the central venous catheter group compared to 88 days in the totally implanted access port group.
A higher incidence of catheter related infections was observed in patients with central venous catheters in contrast to patients with totally implanted access ports were venous thrombosis was more frequent.
血栓形成和感染是中心静脉导管和完全植入式接入端口的已知并发症。这些并发症会导致住院时间延长、抗生素使用增加和需要更换，从而增加成本。本研究的目的是记录癌症患者中心静脉导管和完全植入式胸部端口相关的血栓形成和感染的发生情况，并研究因子 V 莱顿是否是导管相关血栓形成的危险因素。
2002 年 2 月至 2004 年 11 月，43 例中心静脉导管或完全植入式接入端口患者接受随访，以记录导管相关血栓形成和感染的发生情况。患者接受化疗，治疗血液系统恶性肿瘤或实体瘤。通过限制性片段长度多态性分析确定因子 V 莱顿（R506Q）。随访期于 2007 年 4 月结束。
4 例（4/43；9.3%）完全植入式接入端口患者发生导管相关血栓形成。3 例因子 V 莱顿患者均无导管相关感染或血栓形成。15 例患者发生导管相关感染：10 例（23.3%；10/43）中心静脉导管和 5 例（11.6%；5/43）完全植入式接入端口。中心静脉导管组感染时间为 32.5 天，而完全植入式接入端口组为 88 天。
与完全植入式接入端口患者相比，中心静脉导管患者的导管相关感染发生率更高，而静脉血栓形成更常见。
