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静脉输液港植入标准算法的长期结果

Long-Term Results of a Standard Algorithm for Intravenous Port Implantation.

作者信息

Wu Ching-Feng, Fu Jui-Ying, Wen Chi-Tsung, Chiu Chien-Hung, Hsieh Ming-Ju, Liu Yun-Hen, Liu Hui-Ping, Wu Ching-Yang

机构信息

Department of Surgery, Thoracic and Cardiovascular Surgery Division, Chang Gung Memorial Hospital, Linkou 333423, Taiwan.

Medical Department, Medical College, Chang Gung University, Taoyuan 333323, Taiwan.

出版信息

J Pers Med. 2021 Apr 24;11(5):344. doi: 10.3390/jpm11050344.

Abstract

Intravenous ports serve as vascular access and are indispensable in cancer treatment. Most studies are not based on a systematic and standardized approach. Hence, the aim of this study was to demonstrate long-term results of port implantation following a standard algorithm. A total of 2950 patients who underwent intravenous port implantation between March 2012 and December 2018 were included. Data of patients managed following a standard algorithm were analyzed for safety and long-term outcomes. The cephalic vein was the predominant choice of entry vessel. In female patients, wire assistance without use of puncture sheath was less likely and echo-guided puncture via internal jugular vein (IJV) with use of puncture sheath was more likely to be performed, compared to male patients ( < 0.0001). The procedure-related complication rate was 0.07%, and no pneumothorax, hematoma, catheter kinking, catheter fracture, or pocket erosion was reported. Catheter implantations by echo-guided puncture via IJV notably declined from 4.67% to 0.99% ( = 0.027). Mean operative time gradually declined from 37.88 min in 2012 to 23.20 min in 2018. The proposed standard algorithm for port implantation reduced the need for IJV echo-guided approach and eliminated procedure-related catastrophic complications. In addition, it shortened operative time and demonstrated good functional results.

摘要

静脉输液港作为血管通路在癌症治疗中不可或缺。大多数研究并非基于系统和标准化的方法。因此,本研究的目的是展示遵循标准算法进行输液港植入的长期结果。纳入了2012年3月至2018年12月期间接受静脉输液港植入的2950例患者。对遵循标准算法管理的患者数据进行安全性和长期结果分析。头静脉是主要的入路血管选择。与男性患者相比,女性患者较少采用无穿刺鞘的导丝辅助,而更可能采用经颈内静脉(IJV)超声引导穿刺并使用穿刺鞘(<0.0001)。与操作相关的并发症发生率为0.07%,未报告气胸、血肿、导管扭结、导管断裂或囊袋侵蚀。经IJV超声引导穿刺的导管植入率从4.67%显著下降至0.99%(=0.027)。平均手术时间从2012年的37.88分钟逐渐降至2018年的23.20分钟。所提出的输液港植入标准算法减少了对IJV超声引导方法的需求,并消除了与操作相关的灾难性并发症。此外,它缩短了手术时间并显示出良好的功能结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d01/8146737/87597df597f3/jpm-11-00344-g001.jpg

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