Repelaer van Driel O J, Kuin C M, van de Velde C J
Department of Surgery and Medical Oncology, University Hospital Leiden, The Netherlands.
Neth J Surg. 1988 Jun;40(4):97-9.
Subcutaneously implanted venous access devices allow prolonged access with a minimum of discomfort for patients with inadequate peripheral veins or chemotherapy-induced recurrent thrombophlebitis. In 45 cancer patients, 49 venous access devices (Port-A-Cath) were implanted subcutaneously by means of a venous cut-down technique to avoid the risk of pneumothorax. Most catheters were implanted in the deltapectoral groove under local anaesthesia with lidocaine 0.5% and guided by fluoroscopy. The cumulative function time was 22.6 patient years (1177 weeks), the mean function time 24 weeks (range 0-98 weeks). No serious complications were seen. There were two local infections and four occlusions. The patency could be restored in three of these four. Surgical implantation of venous access devices, under local anaesthesia, is a safe method to establish central venous access in cancer patients. The complication rate is low in comparison with percutaneous catheters or AV-fistulas.
皮下植入式静脉通路装置可为外周静脉条件不佳或化疗引起复发性血栓性静脉炎的患者提供长时间的静脉通路，且患者不适感降至最低。45例癌症患者通过静脉切开技术皮下植入49个静脉通路装置（Port-A-Cath），以避免气胸风险。多数导管在0.5%利多卡因局部麻醉下，于三角胸肌沟植入，并在荧光镜引导下进行。累积使用时间为22.6患者年（1177周），平均使用时间24周（范围0 - 98周）。未观察到严重并发症。发生了2例局部感染和4例堵塞。这4例中有3例的通畅性得以恢复。在局部麻醉下手术植入静脉通路装置是为癌症患者建立中心静脉通路的一种安全方法。与经皮导管或动静脉内瘘相比，并发症发生率较低。
