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采用新型一次性技术在超声引导下置入输液港:胸部并发症

Ultrasound-guided port-a-cath positioning with the new one-shoot technique: thoracic complications.

作者信息

Cajozzo M, Palumbo V D, Mannino V, Geraci G, Lo Monte A I, Caronia F P, Fatica F, Romano G, Puzhlyakov V, D'Anna R, Cocchiara G

机构信息

Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo.

Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo - Euro-Mediterranean Institute of Science and Technology (IEMEST), Palermo.

出版信息

Clin Ter. 2018 Nov-Dec;169(6):e277-e280. doi: 10.7417/CT.2018.2093.

Abstract

OBJECTIVES

Port-a-cath catheterization is often required for those patients who need long-term therapies (malnutrition, neoplasm, renal failure, other severe diseases). The use of ports for a wide range of indications is not exempt from complications. Ultrasound-guided central venous catheterization (CVC) is a safe and fast technique for the introduction of the catheter inside a central vein. This retrospective study reports our experience with US-guided CVC in patient eligible for port-a-cath implantation.

MATERIALS AND METHODS

From January 2007 to March 2017, 108 CVC (out of 770 procedures), were positioned using an ultrasound guide, with the new "one-shoot technique" (group 1) and the classic Seldinger technique (group 2).

RESULTS

One-shoot techniques showed a reduced operative time, in comparison to Seldinger technique, with a negligible minor complication rate. No major complication were evidenced.

CONCLUSIONS

CVC is a safe procedure, although not free from complications. Ultrasonography enhances safety of the procedure by decreasing puncture attempts and complications; it is helpful in patients with vascular anatomical variations, with no visualized or palpable landmarks or for patients with coagulation disorders.

摘要

目的

对于那些需要长期治疗(营养不良、肿瘤、肾衰竭及其他严重疾病)的患者,通常需要进行植入式静脉输液港置管。广泛应用静脉输液港并非没有并发症。超声引导下中心静脉置管(CVC)是一种将导管置入中心静脉的安全、快速的技术。这项回顾性研究报告了我们在符合植入式静脉输液港植入条件的患者中应用超声引导下CVC的经验。

材料与方法

2007年1月至2017年3月,在770例操作中,108例CVC采用超声引导,分别采用新的“一针法”(第1组)和经典的塞丁格技术(第2组)进行置管。

结果

与塞丁格技术相比,一针法的手术时间缩短,轻微并发症发生率可忽略不计。未发现严重并发症。

结论

CVC是一种安全的操作,尽管并非没有并发症。超声检查通过减少穿刺次数和并发症提高了操作的安全性;它对血管解剖变异、无可见或可触及标志的患者或有凝血障碍的患者有帮助。

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