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可动力注射的完全植入式静脉通路装置——超声引导植入成功率及并发症发生率分析与患者满意度调查

Power-injectable totally implantable venous access devices - analysis of success and complication rates of ultrasound-guided implantation and a patient satisfaction survey.

作者信息

Kunz-Virk Julia, Krüger Karsten

机构信息

Department of Radiology and Interventional Therapy, Vivantes Humboldt Hospital and Spandau Hospital, Berlin, Germany.

出版信息

Vasa. 2019 Nov;48(6):524-530. doi: 10.1024/0301-1526/a000802. Epub 2019 May 24.

Abstract

To retrospectively evaluate the success rates, peri-interventional, early and late complications and patient satisfaction associated with power-injectable totally implantable venous access devices (TIVAPs). Between April 2011 and March 2016, a total of 1,203 TIVAPs were implanted in 1,169 patients. Ultrasound-guided, fluoroscopically controlled implantation was performed through the subclavian or internal jugular vein. The systematic analysis focused on the rate of successful port implantations, the frequency of peri-interventional, early and late complications and on how the experience of the implanting radiologist impacts these parameters. Additionally, a standardized questionnaire was administered to the 102 study patients in a telephone interview to survey their subjective rating of the port implantation. 99.5 % of TIVAPs were implanted successfully. In 4 out of 6 patients, the implantation was repeated successfully at a later time. Complication rates were 1.4 % (0.0512/1.000 catheter days) for peri-interventional, 2.9 % (0.081 per 1,000 catheter days) for early and 8.3 % (0.2288 per 1,000 catheter days) for late complications. The radiologist's experience level and vein selection did not have a significant impact. Most peri-interventional complications (82.4 %) were of minor severity. The early (61.5 %) and late (65.6 %) complications were more frequently of major severity. Interventions to manage complications comprised port explanation in 46.9 %, conservative therapy in 17.4 % and interventional therapy in 12.2 %. At 1 and 3 months after port placement, the majority were satisfied or very satisfied with the interventional port implantation. Ultrasound-guided, fluoroscopically controlled implantation of TIVAPs is a safe procedure with low complication rates, high success rates and high patient satisfaction.

摘要

回顾性评估动力注射式全植入式静脉通路装置(TIVAP)的成功率、介入期、早期和晚期并发症以及患者满意度。2011年4月至2016年3月期间,共为1169例患者植入了1203个TIVAP。通过锁骨下静脉或颈内静脉在超声引导、透视控制下进行植入。系统分析集中在端口植入成功率、介入期、早期和晚期并发症的发生率以及植入放射科医生的经验如何影响这些参数。此外,通过电话访谈对102例研究患者进行了标准化问卷调查,以调查他们对端口植入的主观评价。99.5%的TIVAP成功植入。6例患者中有4例在之后成功重复植入。介入期并发症发生率为1.4%(每1000导管日0.0512),早期为2.9%(每1000导管日0.081),晚期为8.3%(每1000导管日0.2288)。放射科医生的经验水平和静脉选择没有显著影响。大多数介入期并发症(82.4%)为轻度。早期(61.5%)和晚期(65.6%)并发症更常为重度。处理并发症的干预措施包括端口解释占46.9%、保守治疗占17.4%和介入治疗占12.2%。在端口放置后1个月和3个月,大多数患者对介入性端口植入感到满意或非常满意。超声引导、透视控制下的TIVAP植入是一种安全的手术,并发症发生率低、成功率高且患者满意度高。

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