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儿童癌症患者的 Groshong 导管相关并发症。

Groshong catheter-related complications in children with cancer.

机构信息

Division of Pediatric Oncology, Department of Pediatrics, Catholic University, A. Gemelli Hospital, Rome, Italy.

出版信息

Pediatr Blood Cancer. 2010 Jul 1;54(7):947-51. doi: 10.1002/pbc.22416.

Abstract

BACKGROUND

Children with cancer undergo intensive treatments requiring reliable vascular access. Central venous catheters (CVCs) reduce discomfort due to venipuncture and the risks of extravasations from chemotherapy administration. The aim of our retrospective study was to assess safety and complications of Groshong devices in children with cancer.

PATIENTS AND METHODS

One hundred ninety Groshong CVCs were placed in 166 children over a 5-year period. Early complications, and infectious and mechanical events were collected.

RESULTS

The mean period of permanence of the CVCs was 330 days per patient (range 7-1,037). Of the febrile episodes, 36 (34.6%) were CVC-related, with an incidence rate of 0.56 per 1,000 CVC days. Severe neutropenia conditions most of all complicated CVC-related infectious events (94.4%) and Gram-negative bacteria were those most often isolated (55%). Twenty CVCs were affected by mechanical or thrombotic complications, with an incidence of 0.33 episodes per 1,000 CVC days. Mechanical complications led to CVC removal in 6 (3.1%) cases, while CVC-related infective episodes were responsible for 10 (5.2%) CVC removals.

CONCLUSIONS

The long in situ duration of this device allowed it to be safely employed from the beginning to the end of the treatment period in most children.

摘要

背景

患有癌症的儿童需要接受密集的治疗,这需要可靠的血管通路。中心静脉导管(CVC)可减少因静脉穿刺引起的不适以及化疗给药外渗的风险。我们回顾性研究的目的是评估 Groshong 装置在癌症儿童中的安全性和并发症。

患者和方法

在 5 年期间,166 名儿童共植入了 190 根 Groshong CVC。收集了早期并发症以及感染和机械事件。

结果

CVC 每位患者的平均留置时间为 330 天(范围 7-1037 天)。发热事件中,36 例(34.6%)与 CVC 相关,发生率为每 1000 个 CVC 天 0.56 例。严重中性粒细胞减少症最常导致 CVC 相关感染事件(94.4%),革兰氏阴性菌最常被分离(55%)。20 根 CVC 发生机械或血栓并发症,发生率为每 1000 个 CVC 天 0.33 例。机械并发症导致 6 例(3.1%)CVC 拔除,而 CVC 相关感染事件导致 10 例(5.2%)CVC 拔除。

结论

该设备在体内留置时间较长,可在大多数儿童的治疗期间从开始到结束安全使用。

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