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用于化疗的连接有带阀导管的完全植入式端口:350个Groshong装置的经验

Totally implantable ports connected to valved catheters for chemotherapy: experience from 350 Groshong devices.

作者信息

Nishinari Kenji, Wolosker Nelson, Bernardi Christiano Vinicius, Yazbek Guilherme

机构信息

Department of Vascular Surgery, Hospital A.C. Camargo, São Paulo, Brazil.

出版信息

J Vasc Access. 2010 Jan-Mar;11(1):17-22. doi: 10.1177/112972981001100104.

Abstract

PURPOSE

There are few studies regarding the use of totally implantable valved ports for chemotherapy. The objective of this study was to analyze the results obtained from consecutive implantation of 350 devices.

METHODS

Adult patients submitted to port insertion in veins of the superior vena cava system over a 17-month period (July 2006 to December 2007) were considered. The device used was composed of a titanium and silicone rubber port (Dome Port; Bard Inc, Salt Lake City, UT) connected to an 8.0 Fr silastic Groshong catheter tube. Follow-up was conducted on outpatient data and during clinical readmissions, until the device was removed or the patient died.

RESULTS

Three hundred and fifty devices, total of 74,691 days in situ, were inserted, with a median follow-up of 176 days. There were 11 early complications (3.1%) and 49 late complications (14%), 21 of these (6%) were considered major ones. Early complications comprised four instances of phlebitis of the external jugular, three of pocket infection, two of technical failure and two of ecchymosis. Late complications comprised 33 instances of withdrawal difficulty, 12 of port-related bacteremia, two of deep venous thrombosis, one of occlusion and one of catheter fracture. Out of the 350 catheters implanted, 258 (73.5%) were still being used, 73 (21%) remained in use until the patient died, five (1.5%) were removed at the end of the treatment and 14 (4%) were removed because of complications.

CONCLUSIONS

There was a low rate of major complications associated with this valved system justifying its use.

摘要

目的

关于使用完全植入式带瓣膜端口进行化疗的研究较少。本研究的目的是分析连续植入350个装置所获得的结果。

方法

纳入在17个月期间(2006年7月至2007年12月)接受上腔静脉系统静脉端口植入的成年患者。所使用的装置由钛和硅橡胶端口(圆顶端口;巴德公司,犹他州盐湖城)连接到8.0 Fr硅橡胶格罗申导管组成。对门诊数据和临床再次入院期间进行随访,直至装置移除或患者死亡。

结果

共植入350个装置,原位总时长74,691天,中位随访时间为176天。有11例早期并发症(3.1%)和49例晚期并发症(14%),其中21例(6%)被认为是主要并发症。早期并发症包括4例颈外静脉炎、3例囊袋感染、2例技术故障和2例瘀斑。晚期并发症包括33例拔管困难、12例与端口相关的菌血症、2例深静脉血栓形成、1例堵塞和1例导管断裂。在植入的350根导管中,258根(73.5%)仍在使用,73根(21%)在患者死亡前仍在使用,5根(1.5%)在治疗结束时移除,14根(4%)因并发症而移除。

结论

该带瓣膜系统相关的主要并发症发生率较低,证明其使用是合理的。

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