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全植入式输液港的并发症及枸橼酸牛磺罗定封管液预防导管相关感染的疗效

Complications of total implantable access ports and efficacy of Taurolidine-citrate lock solution against catheter-related infections.

作者信息

Ince Emine, Oğuzkurt Pelin, Temiz Abdulkerim, Ezer Semire Serin, Gezer Hasan Özkan, Yazici Nalan, Hiçsönmez Akgün

机构信息

Department of Paediatric Surgery, Başkent University, Faculty of Medicine, Ankara, Turkey.

出版信息

Afr J Paediatr Surg. 2014 Apr-Jun;11(2):138-42. doi: 10.4103/0189-6725.132806.

Abstract

BACKGROUND

Totally, implantable access ports (TIAPs) are used for long standing venous catheterization. This study was designed to present our experiences of the TIAPs applications and efficacy of Taurolidine-citrate lock solution (TCLS) against catheter-related infections.

MATERIALS AND METHODS

We evaluated records of the 108 patients implanted with 112 TIAPs, which had been performed using heparin solution or TCLS between 2005 and 2013.

RESULTS

Duration of exposure to TIAPs was 17-2051 days (median: 411 days). The primary diagnoses were solid tumours (n = 57), lymphoma (n = 23), haematologic diseases (n = 23), nephrotic syndrome (n = 4), Hirschsprung disease (n = 1). The right external jugular vein was most frequently used vascular access route (72.3%). Mechanical complications were observed in four cases. TIAPs were removed due to remission in 19 cases and infection in 19 cases. Median time from implantation and to the development of infection was 60 days. Heparin solution had been used for care in 33 ports, whereas heparin and TCLS had been used in 79 ports. Based on statistical comparison, use of TCLS was considered to be an important factor for preventing infection (P = 0.03).

CONCLUSION

We consider that TCLS reduces infection prevalence so TIAPs would be used more extensively and effectively to prevent infections.

摘要

背景

完全植入式输液港(TIAPs)用于长期静脉置管。本研究旨在介绍我们应用TIAPs的经验以及柠檬酸盐硫代罗丹宁锁定溶液(TCLS)预防导管相关感染的效果。

材料与方法

我们评估了2005年至2013年间108例植入112个TIAPs患者的记录,这些患者使用肝素溶液或TCLS进行置管。

结果

TIAPs的使用时间为17 - 2051天(中位数:411天)。主要诊断为实体瘤(n = 57)、淋巴瘤(n = 23)、血液系统疾病(n = 23)、肾病综合征(n = 4)、先天性巨结肠(n = 1)。最常使用的血管通路是右颈外静脉(72.3%)。观察到4例机械并发症。因病情缓解拔除TIAPs 19例,因感染拔除19例。从植入到发生感染的中位时间为60天。33个端口使用肝素溶液护理,79个端口使用肝素和TCLS护理。基于统计学比较,使用TCLS被认为是预防感染的重要因素(P = 0.03)。

结论

我们认为TCLS可降低感染发生率,因此TIAPs将更广泛、有效地用于预防感染。

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