Wu Ching-Yang, Fu Jui-Ying, Wu Ching-Feng, Hsieh Ming-Ju, Wen Chi-Tsung, Cheng Chia-Hui, Liu Yun-Hen, Ko Po-Jen
Thoracic and Cardiovascular Surgery Division, Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.
Chest Division, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.
Ann Vasc Surg. 2019 Oct;60:193-202. doi: 10.1016/j.avsg.2019.02.030. Epub 2019 May 8.
Adequate tip location is crucial for intravenous port implantation because it can minimize catheter-related complications. Adequate tip location cannot be observed directly and needs to be confirmed by imaging tools. A quantified intravascular catheter length formula has been proposed and we attempt to compare its clinical effectiveness with anatomic landmark references.
During the period from March 2012 to February 2013, 503 patients who received port implantation where implanted catheter length depended on carina level as confirmed by intraoperative fluoroscopy were assigned to Group A. From March 2013 to February 2014, 521 patients who received port implantation based on quantified intravascular catheter length formula were assigned to Group B. Clinical outcomes were compared.
Catheter tip location of Group A, as revealed by intraoperative fluoroscopy and postoperative chest film, was 1.18 ± 0.51 and 1.1 ± 1.3 cm below carina, respectively. Catheter tip location of Group B, as revealed by intraoperative fluoroscopy and postoperative chest film, was 1.25 ± 1.05 and 1.05 ± 1.32 cm below carina, respectively. Similar catheter tip location was identified in both groups. The functional period of implanted ports, complication rate (3.58% and 2.53%), and incidence (0.049 and 0.0506 episodes/1,000 catheter days) were similar in both groups.
The quantified intravascular catheter length formula can predict an adequate catheter length just as well as carina do and results in good catheter tip location. The formula could replace the clinical use of anatomic landmarks and serve as an easy tool for practitioners.
合适的导管尖端位置对于静脉输液港植入至关重要，因为它可以将导管相关并发症降至最低。合适的导管尖端位置无法直接观察到，需要通过成像工具来确认。已经提出了一种量化的血管内导管长度公式，我们试图将其临床效果与解剖标志参考进行比较。
在2012年3月至2013年2月期间，503例接受输液港植入的患者被分配到A组，其植入导管长度取决于术中透视确认的隆突水平。在2013年3月至2014年2月期间，521例根据量化血管内导管长度公式接受输液港植入的患者被分配到B组。比较两组的临床结果。
术中透视和术后胸片显示，A组导管尖端位置分别在隆突下方1.18±0.51 cm和1.1±1.3 cm处。术中透视和术后胸片显示，B组导管尖端位置分别在隆突下方1.25±1.05 cm和1.05±1.32 cm处。两组导管尖端位置相似。两组植入输液港的功能期、并发症发生率（3.58%和2.53%）和发生率（0.049和0.0506次/1000导管日）相似。
量化的血管内导管长度公式在预测合适的导管长度方面与隆突一样好，并且能使导管尖端位置良好。该公式可以取代解剖标志的临床应用，为从业者提供一种简便的工具。
