Kappers-Klunne M C, Degener J E, Stijnen T, Abels J
Department of Hematology, University Hospital Dijkzigt, Rotterdam, The Netherlands.
Cancer. 1989 Oct 15;64(8):1747-52. doi: 10.1002/1097-0142(19891015)64:8<1747::aid-cncr2820640832>3.0.co;2-f.
Forty-three evaluable patients with hematologic malignancies, mainly acute leukemia, were prospectively randomized to receive a double lumen central venous catheter or a totally implantable venous access system. The mean catheter stay was 166 days (median, 104 days) for the 23 double lumen catheters and 164 days (median, 65 days) for implanted systems. Exit site infections were not encountered in double lumen catheters, but there were two proven infections around the injection port of implanted devices. Tunnel infections did not occur. Seven double lumen catheters and four implanted systems were removed because of infection. Staphylococcus epidermidis was the predominant microorganism cultured from these catheters. Five of nine patients with double lumen catheters and catheter-related S. epidermidis infection and the two patients with implanted systems in whom S. epidermidis was cultured were on selective gut decontamination. The pattern of infection did not seem to be influenced by this regimen. Totally implantable systems proved to be as safe as double lumen central venous lines.
43例血液系统恶性肿瘤患者（主要为急性白血病）被前瞻性随机分组，分别接受双腔中心静脉导管或完全植入式静脉通路系统。23根双腔导管的平均置管时间为166天（中位数为104天），植入式系统的平均置管时间为164天（中位数为65天）。双腔导管未发生出口部位感染，但植入装置注射端口周围有2例确诊感染。未发生隧道感染。7根双腔导管和4个植入式系统因感染被拔除。表皮葡萄球菌是从这些导管中培养出的主要微生物。9例双腔导管且发生导管相关表皮葡萄球菌感染的患者中有5例以及2例培养出表皮葡萄球菌的植入式系统患者正在接受选择性肠道去污处理。感染模式似乎未受该方案影响。完全植入式系统被证明与双腔中心静脉导管一样安全。
