留置隧道导管成功用于管理晚期癌症患儿的积液。

Successful use of indwelling tunneled catheters for the management of effusions in children with advanced cancer.

机构信息

Division of Haematology/Oncology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; Department of Pediatric Oncology/Haematology, Erasmus MC-Sophia Children's Hospital, University of Rotterdam, Rotterdam, The Netherlands.

出版信息

Pediatr Blood Cancer. 2014 Jun;61(6):1007-12. doi: 10.1002/pbc.24902. Epub 2013 Dec 23.

DOI:10.1002/pbc.24902

PMID:24376007

Abstract

BACKGROUND

Malignant pleural effusion (MPE) and ascites (MA) negatively impact quality of life of palliative patients. Treatment options are limited. This study's purpose is to examine the experience with indwelling tunneled catheters (ITCs) for management of MPE/MA in children with advanced cancer.

METHODS

Children with MPE/MA who underwent ITC insertion (2007-2012) were retrospectively reviewed. Clinical, procedural, complication and outcome details were analyzed.

RESULTS

PleurX® ITCs (n = 12) were inserted in eight patients (5-18 years) with sarcoma (11 MPE, 1 MA), achieving symptom relief and facilitating discharge home post ITC (median 2 days). Median survival following ITC was 51 days. There were two major complications: pain (n = 1), late site infection (n = 1), and five minor complications. Drainage ceased in four patients (pleurodesis/tumor progression). At time of death, six ITCs (five patients) were still in situ.

CONCLUSIONS

ITC appears to be a safe, effective treatment for MPE/MA in advanced pediatric cancer, achieving symptomatic relief and discharge home.

摘要

背景

恶性胸腔积液（MPE）和腹水（MA）会降低姑息治疗患者的生活质量。治疗选择有限。本研究旨在探讨在晚期癌症儿童中使用留置隧道导管（ITC）治疗 MPE/MA 的经验。

方法

回顾性分析了 2007 年至 2012 年间接受 ITC 插入术的 MPE/MA 患儿的临床、手术、并发症和结局资料。

结果

在 8 例患有肉瘤（11 例 MPE，1 例 MA）的儿童中使用了 PleurX® ITC，症状缓解，在 ITC 后可顺利出院回家（中位数 2 天）。ITC 后中位生存时间为 51 天。有两个主要并发症：疼痛（n = 1），迟发性部位感染（n = 1），以及五个小并发症。在 4 例患者中（胸膜固定术/肿瘤进展）停止引流。在死亡时，有 6 个 ITC（5 例患者）仍在原位。