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完全植入式中心静脉导管:辐射暴露与穿刺部位及操作者经验的关系

Totally Implantable Central Venous Port Catheters: Radiation Exposure as a Function of Puncture Site and Operator Experience.

作者信息

Jonczyk Martin, Gebauer Bernhard, Rotzinger Roman, Schnapauff Dirk, Hamm Bernd, Collettini Federico

机构信息

Department of Radiology, Charité - University of Medicine, Berlin, Germany

Berlin Institute of Health, Berlin, Germany.

出版信息

In Vivo. 2018 Jan-Feb;32(1):179-184. doi: 10.21873/invivo.11222.

Abstract

BACKGROUND

Totally implantable central venous port systems provide a safe and effective, long-term means of access for administration of hyperosmolar, local irritant medication, such as chemotherapy, antibiotics and parenteral nutrition.

AIM

To evaluate the combination of access site and level of experience on fluoroscopy times (FT) and dose area products (DAP) during implantation of port catheters in a large patient population.

MATERIALS AND METHODS

A total of 1,870 patients (992 women, 878 men; age: 61±13.14 years) were reviewed investigating two groups of junior (≤50 implantations) and senior (>50) radiologists.

RESULTS

Senior radiologists required less FT/DAP (0.24 s/57.3 μGy m versus 0.43 s/68.2 μGy m, respectively; p<0.001). Right jugular vein access required the least FT/DAP (0.25 s/56.15 μGy m) and right-sided implantation lower FT/DAP (right: 0.26 s/56.4 μGy m, left: 0.40 s/85.10 μGy m, p<0.001).

CONCLUSION

Due to DAP/FT reductions, the right jugular vein seems to be the most favorable implantation side for port systems. For further dose reduction, residents should be well-trained.

摘要

背景

全植入式中心静脉导管系统为高渗性、局部刺激性药物(如化疗药物、抗生素和肠外营养药物)的给药提供了一种安全有效的长期通路。

目的

在大量患者群体中评估在植入端口导管期间,穿刺部位和经验水平对透视时间(FT)和剂量面积乘积(DAP)的影响。

材料与方法

回顾了总共1870例患者(992例女性,878例男性;年龄:61±13.14岁),研究了两组初级(≤50例植入手术)和高级(>50例)放射科医生。

结果

高级放射科医生所需的FT/DAP较少(分别为0.24秒/57.3微戈瑞·米和0.43秒/68.2微戈瑞·米;p<0.001)。右颈内静脉穿刺所需的FT/DAP最少(0.25秒/56.15微戈瑞·米),右侧植入的FT/DAP较低(右侧:0.26秒/56.4微戈瑞·米,左侧:0.40秒/85.10微戈瑞·米,p<0.001)。

结论

由于DAP/FT降低,右颈内静脉似乎是植入端口系统最有利的一侧。为进一步降低剂量,住院医师应接受良好的培训。

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