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270 例经贵要静脉行完全植入式静脉输液港放射影像学引导植入术的结果分析。

Outcome analysis in 270 radiologically guided implantations of totally implantable venous access ports via basilic vein.

机构信息

Department of Radiology, Taichung Veterans General Hospital, Taichung, Taiwan, ROC.

Division of Radiology, Everan Hospital, Taichung, Taiwan, ROC.

出版信息

J Chin Med Assoc. 2020 Mar;83(3):295-301. doi: 10.1097/JCMA.0000000000000265.

Abstract

BACKGROUND

Totally implantable venous access ports (TIVAPs) are widely applied in patients who require chemotherapy, parenteral nutrition, or frequent intravenous drug infusion. Although various venous access routes are possible for TIVAP insertion, the best method remains a topic of controversy. We present a single-center retrospective study of radiologically guided placement of TIVAPs through the basilic vein, with analysis of technical feasibility, patient safety, and device-related complications.

METHODS

We retrospectively reviewed 270 patients who received TIVAP implantation through the basilic vein from November 2013 to July 2016, under imaging guidance by an interventional radiology team at our institution. Fluoroscopic images, chest radiographs, computed tomography scans, and medical records were reviewed after port implantation. Catheter maintenance days were calculated and catheter-related complications were recorded.

RESULTS

The procedural success rate was 99.3%. In total, 270 TIVAPs were implanted in 270 patients, of which 150 remained functional at the end of the study period. The total catheter maintenance days was 77 543 days, and the mean catheter indwelling duration was 287 ± 207 days. In 20 (7.4%) patients, TIVAP-related complications occurred during the follow-up period, resulting in a postprocedural complication rate of 0.26 incidences per 1000 catheter days. No significant relationship was observed between complications and gender (p = 0.188), age (p = 0.528), body mass index (p = 0.547), the type of primary malignancy (p = 0.914), or between the left and right basilic veins (p = 0.319).

CONCLUSION

Real-time ultrasound and fluoroscopic guidance provides a safe method for TIVAP implantation through the basilic vein, with a high technical success rate and few device-related complications.

摘要

背景

完全植入式静脉输液港(TIVAP)广泛应用于需要化疗、肠外营养或频繁静脉药物输注的患者。尽管 TIVAP 插入有多种静脉入路方式,但最佳方法仍存在争议。我们报告了一项单中心回顾性研究,分析了在影像学引导下经贵要静脉植入 TIVAP 的技术可行性、患者安全性和器械相关并发症。

方法

我们回顾性分析了 2013 年 11 月至 2016 年 7 月期间在我院介入放射科团队的影像学引导下接受经贵要静脉植入 TIVAP 的 270 例患者。在植入后,对患者的荧光透视图像、胸片、CT 扫描和病历进行了回顾。计算了导管留置天数,并记录了导管相关并发症。

结果

手术成功率为 99.3%。共植入 270 个 TIVAP,其中 150 个在研究结束时仍保持功能。总导管留置天数为 77543 天,平均导管留置时间为 287±207 天。在 20 例(7.4%)患者中,在随访期间发生了 TIVAP 相关并发症,导致术后并发症发生率为每 1000 导管日 0.26 例。并发症与性别(p=0.188)、年龄(p=0.528)、体重指数(p=0.547)、原发性恶性肿瘤类型(p=0.914)或左右贵要静脉之间无显著关系(p=0.319)。

结论

实时超声和荧光透视引导为经贵要静脉植入 TIVAP 提供了一种安全的方法,具有较高的技术成功率和较少的器械相关并发症。

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