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中心静脉端口系统的并发症:图文综述

Complications of central venous port systems: a pictorial review.

作者信息

Machat Sibylle, Eisenhuber Edith, Pfarl Georg, Stübler Josef, Koelblinger Claus, Zacherl Johannes, Schima Wolfgang

机构信息

Department of Diagnostic and Interventional Radiology, Sankt Josef Krankenhaus, Goettlicher Heiland Krankenhaus, and Barmherzige Schwestern Krankenhaus, Auhofstrasse 189, 1130, Vienna, Austria.

Department of Radiology, Barmherzige Schwestern Krankenhaus, Ried, Austria.

出版信息

Insights Imaging. 2019 Aug 28;10(1):86. doi: 10.1186/s13244-019-0770-2.

Abstract

Central venous port devices are indicated for patients, who need long-term intravenous therapy. Oncologic patients may require intermittent administration of chemotherapy, parenteral nutrition, infusions, or blood transfusions. A venous port system is composed of a port chamber attached to a central catheter, which is implanted into the central venous system. The subcutaneous location of the catheter chamber improves the patients' quality of life and the infection rate is lower than in non-totally implantable central venous devices. However, proper implantation, use, and care of a port system are important to prevent short- and long-term complications. Most common early complications (< 30 days) include venous malpositioning of catheter and perforation with arterial injury, pneumothorax, hemothorax, thoracic duct injury, or even cardiac tamponade. Delayed complications include infection, catheter thrombosis, vessel thrombosis and stenosis, catheter fracture with extravasation, or fracture with migration or embolization of catheter material. Radiologic imaging has become highly relevant in intra-procedural assessment and postoperative follow-up, for detection of possible complications and to plan intervention, e.g., in case of catheter migration. This pictorial review presents the normal imaging appearance of central venous port systems and demonstrates imaging features of short- and long-term complications.

摘要

中心静脉端口装置适用于需要长期静脉治疗的患者。肿瘤患者可能需要间歇性进行化疗、肠外营养、输液或输血。静脉端口系统由连接到中心导管的端口腔组成,该中心导管植入中心静脉系统。导管腔的皮下位置改善了患者的生活质量,且感染率低于非完全植入式中心静脉装置。然而,端口系统的正确植入、使用和护理对于预防短期和长期并发症很重要。最常见的早期并发症(<30天)包括导管静脉位置异常和伴有动脉损伤的穿孔、气胸、血胸、胸导管损伤,甚至心脏压塞。延迟并发症包括感染、导管血栓形成、血管血栓形成和狭窄、导管断裂伴渗漏、或导管材料断裂伴迁移或栓塞。放射影像学在术中评估和术后随访中变得高度相关,用于检测可能的并发症并规划干预措施,例如在导管迁移的情况下。这篇图文综述展示了中心静脉端口系统的正常影像学表现,并演示了短期和长期并发症的影像学特征。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3600/6713776/f28c34e6e3ff/13244_2019_770_Fig1_HTML.jpg

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