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用于化疗的完全植入式静脉导管的肱静脉置入:35例患者的并发症及生活质量评估

Brachial insertion of fully implantable venous catheters for chemotherapy: complications and quality of life assessment in 35 patients.

作者信息

Fonseca Igor Yoshio Imagawa, Krutman Mariana, Nishinari Kenji, Yazbek Guilherme, Teivelis Marcelo Passos, Bomfim Guilherme André Zottele, Cavalcante Rafael Noronha, Wolosker Nelson

机构信息

Fundação Antônio Prudente, Hospital A. C. Camargo, São Paulo, SP, Brazil.

Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.

出版信息

Einstein (Sao Paulo). 2016 Oct-Dec;14(4):473-479. doi: 10.1590/S1679-45082016AO3606.

DOI:10.1590/S1679-45082016AO3606
PMID:28076593
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5221372/
Abstract

OBJECTIVE

To prospectively evaluate the perioperative safety, early complications and satisfaction of patients who underwent the implantation of central catheters peripherally inserted via basilic vein.

METHODS

Thirty-five consecutive patients with active oncologic disease requiring chemotherapy were prospectively followed up after undergoing peripheral implantation of indwelling venous catheters, between November 2013 and June 2014. The procedures were performed in the operating room by the same team of three vascular surgeons. The primary endpoints assessed were early postoperative complications, occurring within 30 days after implantation. The evaluation of patient satisfaction was based on a specific questionnaire used in previous studies.

RESULTS

In all cases, ultrasound-guided puncture of the basilic vein was feasible and the procedure successfully completed. Early complications included one case of basilic vein thrombophlebitis and one case of pocket infection that did not require device removal. Out of 35 patients interviewed, 33 (94.3%) would recommend the device to other patients.

CONCLUSION

Implanting brachial ports is a feasible option, with low intraoperative risk and similar rates of early postoperative complications when compared to the existing data of the conventional technique. The patients studied were satisfied with the device and would recommend the procedure to others.

OBJETIVO

Avaliar prospectivamente segurança perioperatória, complicações precoces e grau de satisfação de pacientes submetidos ao implante de cateteres centrais de inserção periférica pela veia basílica.

MÉTODOS: Foram acompanhados prospectivamente e submetidos ao implante de cateteres de longa permanência de inserção periférica, entre novembro de 2013 e junho de 2014, 35 pacientes consecutivos com doença oncológica ativa necessitando de quimioterapia. Os procedimentos foram realizados em centro cirúrgico por uma mesma equipe composta por três cirurgiões vasculares. Os desfechos primários avaliados foram as complicações pós-operatórias precoces, ocorridas em até 30 dias após o implante. A avaliação do grau de satisfação foi realizada com base na aplicação de um questionário específico já utilizado em estudos prévios.

RESULTADOS

Em todos os casos, a punção ecoguiada da veia basílica foi possível, e o procedimento foi concluído com sucesso. As complicações precoces observadas incluíram um caso de tromboflebite de basílica e um de infecção de bolsa, ambos tratados clinicamente sem necessidade de retirada do dispositivo. Dos 35 pacientes interrogados, 33 (94,3%) recomendariam o dispositivo para outras pessoas.

CONCLUSÃO: A implantação do port braquial é uma opção factível, com baixo risco intraoperatório e taxas semelhantes de complicações pós-operatórias imediatas quando comparada a dados já existentes da técnica convencional. Os pacientes estudados apresentaram-se satisfeitos com o dispositivo e recomendariam o procedimento para outras pessoas.

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/348a/5221372/a2bfff7afaf4/1679-4508-eins-14-04-0473-gf02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/348a/5221372/a61b6b3b7242/1679-4508-eins-14-04-0473-gf01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/348a/5221372/a2bfff7afaf4/1679-4508-eins-14-04-0473-gf02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/348a/5221372/a61b6b3b7242/1679-4508-eins-14-04-0473-gf01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/348a/5221372/a2bfff7afaf4/1679-4508-eins-14-04-0473-gf02.jpg
摘要

目的

前瞻性评估经贵要静脉外周插入中心静脉导管患者的围手术期安全性、早期并发症及患者满意度。

方法

2013年11月至2014年6月,对35例因活动性肿瘤疾病需化疗且接受外周留置静脉导管植入术的患者进行前瞻性随访。手术由同一组三名血管外科医生在手术室完成。评估的主要终点是植入后30天内发生的早期术后并发症。患者满意度评估基于先前研究中使用的特定问卷。

结果

所有病例中,超声引导下贵要静脉穿刺均可行,手术成功完成。早期并发症包括1例贵要静脉血栓性静脉炎和1例囊袋感染,均无需取出装置。在接受访谈的35例患者中,33例(94.3%)会向其他患者推荐该装置。

结论

与传统技术现有数据相比,植入臂部端口是一种可行的选择,术中风险低,术后早期并发症发生率相似。所研究的患者对该装置满意,并会向他人推荐该手术。

目的

前瞻性评估经贵要静脉外周插入中心静脉导管患者的围手术期安全性、早期并发症及患者满意度。

方法

2013年11月至2014年6月,对35例因活动性肿瘤疾病需化疗且接受外周留置静脉导管植入术的患者进行前瞻性随访。手术由同一组三名血管外科医生在手术室完成。评估的主要终点是植入后30天内发生的早期术后并发症。患者满意度评估基于先前研究中使用的特定问卷。

结果

所有病例中,超声引导下贵要静脉穿刺均可行,手术成功完成。观察到的早期并发症包括1例贵要静脉血栓性静脉炎和1例囊袋感染,均经临床治疗,无需取出装置。在接受访谈的35例患者中,33例(94.3%)会向其他患者推荐该装置。

结论

与传统技术现有数据相比,植入臂部端口是一种可行的选择,术中风险低,术后早期并发症发生率相似。所研究的患者对该装置满意,并会向他人推荐该手术。

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Comparative study of valved and nonvalved fully implantable catheters inserted via ultrasound-guided puncture for chemotherapy.经超声引导穿刺插入的带瓣膜和不带瓣膜的全植入式导管用于化疗的对比研究。
Ann Vasc Surg. 2014 Feb;28(2):351-7. doi: 10.1016/j.avsg.2013.01.025. Epub 2013 Oct 3.
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