Greene F L, Moore W, Strickland G, McFarland J
Department of Surgery, University of South Carolina School of Medicine, Columbia 29203.
South Med J. 1988 May;81(5):580-3. doi: 10.1097/00007611-198805000-00010.
Because of the difficulty in maintaining vascular access in patients receiving aggressive parenteral chemotherapy, a growing number of patients have had implantation of either percutaneous or subcutaneous devices allowing permanent intravenous access. In our study, between July 1980 and July 1985, 110 patients had placement of a Broviac catheter, while 100 patients had placement of a subcutaneous device via a subclavian venous approach. Both groups of patients were identical regarding age, primary malignancy, chemotherapy, and nutritional status. Catheter-related sepsis occurred in 15% and thrombotic occlusion in 22% of those patients with Broviac catheters, compared with 3% and 1%, respectively, in patients having subcutaneous reservoirs. Although the initial cost of the subcutaneous reservoir is greater, overall cost of maintenance of the percutaneous catheter far exceeds that of the reservoir because of the need for daily catheter care and heparin flushing of the Broviac device, which is unnecessary for the subcutaneous port. Our experience favors the use of the subcutaneous reservoir in patients receiving prolonged chemotherapy.
由于接受强化胃肠外化疗的患者难以维持血管通路，越来越多的患者植入了经皮或皮下装置以实现永久性静脉通路。在我们的研究中，1980年7月至1985年7月期间，110例患者植入了Broviac导管，而100例患者通过锁骨下静脉途径植入了皮下装置。两组患者在年龄、原发性恶性肿瘤、化疗和营养状况方面相同。使用Broviac导管的患者中，导管相关败血症发生率为15%，血栓形成性闭塞发生率为22%，而使用皮下储液器的患者中，这两个比例分别为3%和1%。尽管皮下储液器的初始成本较高，但由于需要每日护理导管并对Broviac装置进行肝素冲洗，经皮导管的总体维护成本远远超过皮下储液器，而皮下端口则无需如此。我们的经验表明，皮下储液器更适合接受长期化疗的患者。
