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聚氨酯与硅胶植入式静脉输液港:拔除时会发生什么情况?

Polyurethane versus silicone port a cath: What's going on at removal?

作者信息

Alzahrani Khalid, Lejeune Julien, Lakhal Walid, Morel Baptiste, Cook Ann-Rose, Braïk Karim, Lardy Hubert, Binet Aurelien

机构信息

Pediatric Surgery Unit, Hospital Universitary Center of Tours, Gatien de Clocheville Hospital, 37000 Tours, France.

Pediatric Onco-hematology Unit, Hospital Universitary Center of Tours, Gatien de Clocheville Hospital, 37000 Tours, France.

出版信息

J Pediatr Surg. 2018 Jul;53(7):1417-1419. doi: 10.1016/j.jpedsurg.2017.06.025. Epub 2017 Jun 28.

Abstract

BACKGROUND

Port-a-cath (PAC) is an essential device in the management of the patients of chronic illness, but despite theirs benefits there are many complications either at the time of insertion or at time of removal. Our aim of this study is to evaluate the fracture rate of the catheter at removal time in comparison with catheter type either polyurethane or silicone.

METHODS

A retrospective monocentric study of all PACs which were removed at our university pediatric hospital between 1 January 2006 and 31 December 2016. Two groups were compared: polyurethane group and silicone group.

RESULTS

Total of 216 central lines were removed, the mean age at the time of extraction was 9.7±4.9years and the mean time for both catheter was 2.7±1.6years, fracture occurred in 11 catheter of the polyurethane group (n=119), with no fracture of silicone group (n=86), in the polyurethane group, the risk of catheter fracture is significantly related to the duration of the PAC in place.

CONCLUSION

We found that the polyurethane-based catheters are more vulnerable for rupture and retained fragment in the blood vessels, especially if left in place for long time, for this reason we have switched to silicone-based catheter and all catheters should be remove within duration maximal of 2years.

TYPE OF STUDY

Prognosis study.

LEVEL OF EVIDENCE

Level II.

摘要

背景

输液港(PAC)是慢性病患者管理中的重要装置,但尽管有诸多益处,在置入或取出时仍存在许多并发症。本研究的目的是比较聚氨酯或硅胶材质的导管在取出时的断裂率。

方法

对2006年1月1日至2016年12月31日在我院儿科医院取出的所有输液港进行回顾性单中心研究。比较两组:聚氨酯组和硅胶组。

结果

共取出216根中心静脉导管,拔除时的平均年龄为9.7±4.9岁,两种导管的平均留置时间为2.7±1.6年,聚氨酯组(n = 119)有11根导管发生断裂,硅胶组(n = 86)无断裂,在聚氨酯组中,导管断裂风险与输液港的留置时间显著相关。

结论

我们发现基于聚氨酯的导管更容易破裂并在血管中残留碎片,特别是如果长期留置,因此我们已改用基于硅胶的导管,所有导管应在最长2年的时间内取出。

研究类型

预后研究。

证据水平

二级。

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