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静脉港导管断裂及其处理。

Catheter fracture of intravenous ports and its management.

机构信息

Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University, 5 Fu-Shing Street, Kweishan, Taoyuan 333, Taiwan, People's Republic of China.

出版信息

World J Surg. 2011 Nov;35(11):2403-10. doi: 10.1007/s00268-011-1200-x.

Abstract

BACKGROUND

Intravenous ports are widely used for oncology patients. However, catheter fractures may lead to the need for re-intervention. We aimed to identify the risk factors associated with catheter fractures.

METHODS

Between January 1 and December 31, 2006, we retrospectively reviewed the clinical data and plain chest films of 1,505 patients implanted with an intravenous port at Chang Gung Memorial Hospital. Different vascular sites were compared using the chi-square or Fisher's exact test for categorical variables, and the t test was used for continuous variables with normal distribution; P < 0.05 was considered statistically significant.

RESULTS

There were 59 and 1,448 procedures in the fracture and non-fracture groups, respectively. Monovariate analysis revealed that the risk factors for catheter fracture were as follows: large angle (P < 0.0001), female gender (P < 0.0008), subclavian route (P < 0.0001), and port type Arrow French (Fr.) 8.1 (P < 0.0001). Because these risk factors showed no interaction effects, they were all considered independent risk factors. When all factors were considered together, all risk factors, except angle and age, retained their statistical significance.

CONCLUSIONS

Most catheter fractures were caused by material weakness. If catheter fracture is confirmed, further intervention for port and catheter removal is recommended. Female gender, intravenous port implantation via the subclavian route, and the Arrow Fr. 8.1 port were found to be risk factors. Patients with these risk factors should be monitored closely to avoid catheter fractures.

摘要

背景

静脉港在肿瘤患者中广泛应用。然而,导管断裂可能导致需要再次介入。我们旨在确定与导管断裂相关的危险因素。

方法

2006 年 1 月 1 日至 12 月 31 日,我们回顾性分析了长庚纪念医院 1505 例植入静脉港的患者的临床资料和胸部平片。使用卡方检验或 Fisher 确切概率法比较不同血管入路的分类变量,使用 t 检验比较正态分布的连续变量;P<0.05 为差异有统计学意义。

结果

骨折组和非骨折组分别有 59 例和 1448 例。单因素分析显示,导管断裂的危险因素如下:大角度(P<0.0001)、女性(P<0.0008)、锁骨下路径(P<0.0001)和 Arrow 法国 8.1 型(Fr.8.1)静脉港(P<0.0001)。由于这些危险因素之间没有交互作用,因此均被认为是独立的危险因素。当考虑所有因素时,除角度和年龄外,所有危险因素均保留统计学意义。

结论

大多数导管断裂是由材料薄弱引起的。如果确认导管断裂,建议进一步介入取出静脉港和导管。女性、锁骨下静脉置管途径和 Arrow Fr.8.1 型静脉港被认为是危险因素。有这些危险因素的患者应密切监测,以避免导管断裂。

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