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完全植入式静脉端口导管的经验:12年3000例患者分析

Experience in totally implantable venous port catheter: Analysis of 3,000 patients in 12 years.

作者信息

Yanık Fazlı, Karamustafaoğlu Yekta Altemur, Karataş Adem, Yörük Yener

机构信息

Department of Thoracic Surgery, Medicine Faculty of Trakya University, Edirne, Turkey.

出版信息

Turk Gogus Kalp Damar Cerrahisi Derg. 2018 Jul 3;26(3):422-428. doi: 10.5606/tgkdc.dergisi.2018.15299. eCollection 2018 Jul.

Abstract

BACKGROUND

This study aims to present our experience with patients who were performed totally implantable venous port catheter.

METHODS

Demographics-clinical features, surgical results and complications of 3,000 patients (1,824 males, 1,176 females; mean age 61.04±11.5 years; range, 18 to 88 years) who were performed totally implantable venous port catheter between March 2005 and March 2017 were evaluated retrospectively. Totally implantable venous port catheter indications, complications, catheter duration of stay, reasons for catheter removal and statistical analysis information were reported in detail by reviewing patient records.

RESULTS

Of the cases, the Seldinger method was used in 98%, 1% (n=36) had the catheter inserted with superficial Doppler ultrasonography, while the veins were not found in 1% (n=29) and these patients were excluded from the study. Totally implantable venous port catheter was inserted via right internal jugular vein in 2,095 patients (70%), via right subclavian vein in 470 patients (16%), via left internal jugular vein in 290 patients (10%), and via left subclavian vein in 106 patients (3%). Mean duration of stay for totally implantable venous port catheter was 46.7 months (range, 1 to 78 months). Complications were detected in a total of 288 patients (9.6%), 153 (5.1%) being early and 135 (4.5%) being late. The most common oncologic indication was colorectal cancer. The rate of port removal was 298/3,000 (9.9%) and the main reasons were infection, thrombosis, pain, and end of treatment. Totally implantable venous port catheter was required to be inserted twice in 33 patients (1%) and thrice in 14 patients (0.5%). Totally implantable venous port catheter had malposition in eight patients and all were revised successfully with over the guide method.

CONCLUSION

Totally implantable venous port catheter may increase the quality of life in cancer patients. Despite possible complications, totally implantable venous port catheter is safe and comfortable for long-term intravenous treatment. Possible complications may be prevented or managed when totally implantable venous port catheter is performed by surgeons with adequate experience.

摘要

背景

本研究旨在介绍我们在植入全植入式静脉港的患者中的经验。

方法

回顾性评估2005年3月至2017年3月期间接受全植入式静脉港植入的3000例患者(男性1824例,女性1176例;平均年龄61.04±11.5岁;范围18至88岁)的人口统计学-临床特征、手术结果和并发症。通过查阅患者记录详细报告全植入式静脉港的适应症、并发症、导管留置时间、导管拔除原因及统计分析信息。

结果

在这些病例中,98%采用Seldinger法,1%(n = 36)通过浅表多普勒超声引导下插入导管,1%(n = 29)未找到静脉,这些患者被排除在研究之外。2095例患者(70%)通过右颈内静脉插入全植入式静脉港,470例患者(16%)通过右锁骨下静脉插入,290例患者(10%)通过左颈内静脉插入,106例患者(3%)通过左锁骨下静脉插入。全植入式静脉港的平均留置时间为46.7个月(范围1至78个月)。共288例患者(9.6%)出现并发症,其中153例(5.1%)为早期并发症,135例(4.5%)为晚期并发症。最常见的肿瘤适应症是结直肠癌。导管拔除率为298/3000(9.9%),主要原因是感染、血栓形成、疼痛和治疗结束。33例患者(1%)需要二次插入全植入式静脉港,14例患者(...0.5%)需要三次插入。8例患者全植入式静脉港位置不当,均通过导丝引导法成功修正。

结论

全植入式静脉港可提高癌症患者的生活质量。尽管可能存在并发症,但全植入式静脉港对于长期静脉治疗是安全且舒适的。当由经验丰富的外科医生进行全植入式静脉港植入时,可能的并发症可得到预防或处理。 (注:原文中“14例患者(...0.5%)”这里“...”处原文可能有误,推测应为“0.5%”,翻译时按推测补充完整)

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Experience in totally implantable venous port catheter: Analysis of 3,000 patients in 12 years.完全植入式静脉端口导管的经验:12年3000例患者分析
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