完全植入式静脉输液港：一项对比儿童锁骨下静脉和颈内静脉穿刺的前瞻性随机研究。
Totally implantable venous access ports: A prospective randomized study comparing subclavian and internal jugular vein punctures in children.
机构信息
Department of Surgical Oncology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation base of Child development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, P, .R, China; Chongqing Key Laboratory of Pediatrics.
Department of Surgical Oncology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation base of Child development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, P, .R, China; Chongqing Key Laboratory of Pediatrics.
出版信息
J Pediatr Surg. 2021 Feb;56(2):317-323. doi: 10.1016/j.jpedsurg.2020.04.021. Epub 2020 May 6.
BACKGROUND AND OBJECTIVES
Totally implantable venous access ports (TIVAPs) are essential in children who require long-term intermittent intravenous therapy.
METHODS
Patients who needed to undergo TIVAP implantation were randomly assigned to the internal jugular vein group or the subclavian vein group. The medical histories, operative details and major complications from the time of port implantation to 48 h after port removal were collected. During the use of TIVAPs, satisfaction surveys were regularly conducted for the children and guardians and compared in the two groups.
RESULTS
A total of 216 patients in the subclavian vein group and 199 patients in the internal jugular vein group were included. TIVAPs were successfully implanted in all children. The incidence of postoperative venous access occlusion in the subclavian vein group and internal jugular vein group was 1.5% and 5%, respectively, and the difference was statistically significant (P < 0.05). The average satisfaction score of the children and guardians in the subclavian vein group was 9.6 ± 0.3, and that in the internal jugular vein group was 8.3 ± 0.8. There was a significant difference between the 2 groups (P < 0.05).
CONCLUSIONS
Subclavian vein should be the first choice for TIVAP implantation in children.
THE LEVEL OF EVIDENCE RATING
Treatment study level I.
背景与目的
完全植入式静脉输液港（TIVAP）对于需要长期间歇性静脉治疗的儿童至关重要。
方法
需要进行 TIVAP 植入的患者被随机分配到颈内静脉组或锁骨下静脉组。收集从植入端口到移除端口后 48 小时期间的病史、手术细节和主要并发症。在使用 TIVAP 期间，定期对儿童及其监护人进行满意度调查，并在两组之间进行比较。
结果
共纳入锁骨下静脉组 216 例和颈内静脉组 199 例患者。所有儿童均成功植入 TIVAP。锁骨下静脉组和颈内静脉组术后静脉通路阻塞的发生率分别为 1.5%和 5%，差异有统计学意义（P<0.05）。锁骨下静脉组儿童及其监护人的平均满意度评分为 9.6±0.3，颈内静脉组为 8.3±0.8。两组之间存在显著差异（P<0.05）。
结论
锁骨下静脉应为儿童 TIVAP 植入的首选。
证据等级评定
治疗研究水平 I。
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