Teichgräber Ulf K M, Kausche Stephan, Nagel Sebastian N
Institute for Diagnostic and Interventional Radiology, Charité University Medicine, Berlin, Germany.
J Vasc Access. 2011 Oct-Dec;12(4):306-12. doi: 10.5301/JVA.2011.7739.
The aim of this study was to evaluate explantations of central venous port systems that were implanted by interventional radiologists in cases where complications demanded the removal of the port device.
In this retrospective single-center study, explantation rates of central venous port catheter systems (CVPS) associated with complications were investigated over a 10-year period. All CVPS were implanted and explanted in our radiology department's interventional suite. Port catheter dysfunctions were divided into early and late complications, as well as into nonthrombotic and thrombotic events. Indications for implantation and explantation as well as clinical demographics were considered.
One hundred and ninety-three CVPS were removed from 182 patients, due to complications. The total indwelling time of all CVPS was 55,132 catheter-days (mean 285.7; range 1-2,704). The most common diagnoses were gastrointestinal cancers 77 (39.9%) and hematological malignancies 32 (16.6%). Bloodstream infections 134 (69.4%) were the most common indication for the explantation procedure. These were followed by catheter-related thrombosis 28 (14.5%), nonthrombotic CVPS dysfunction 18 (9.3%), port pocket infections 9 (4.7%), and others 4 (2.1%). The highest percentages of explantations related to bloodstream infections were observed in patients with malabsorption (81.8%) and hematological malignancies (81.3%).
Bloodstream infections were the most common cause for port explantation, followed by catheter-related thrombosis. Complication-related explantations were mainly for late-onset complications. Prevention and management strategies should be applied regarding care and usage of port systems to reduce the rate of complication-related explantations.
本研究的目的是评估介入放射科医生植入的中心静脉端口系统在出现并发症需要移除端口装置的情况下的取出情况。
在这项回顾性单中心研究中，调查了10年间与并发症相关的中心静脉端口导管系统（CVPS）的取出率。所有CVPS均在我们放射科的介入手术室植入和取出。端口导管功能障碍分为早期和晚期并发症，以及非血栓性和血栓性事件。考虑了植入和取出的指征以及临床人口统计学特征。
由于并发症，从182例患者中取出了193个CVPS。所有CVPS的总留置时间为55132导管日（平均285.7天；范围1 - 2704天）。最常见的诊断是胃肠道癌77例（39.9%）和血液系统恶性肿瘤32例（16.6%）。血流感染134例（69.4%）是取出手术最常见的指征。其次是导管相关血栓形成28例（14.5%）、非血栓性CVPS功能障碍18例（9.3%）、端口袋感染9例（4.7%）和其他4例（2.1%）。在吸收不良患者（81.8%）和血液系统恶性肿瘤患者（81.3%）中，与血流感染相关的取出率最高。
血流感染是端口取出最常见的原因，其次是导管相关血栓形成。与并发症相关的取出主要是针对迟发性并发症。应针对端口系统的护理和使用应用预防和管理策略，以降低与并发症相关的取出率。
