Koven I H, Sigurdson E R, Rother I, Amato D J, Blackstein M E
Can J Surg. 1987 May;30(3):181-4.
The increasing long-term use of intravenous chemotherapy has resulted in problems of venous access for a number of reasons, one being the sclerosing action of the drugs used. Silastic catheters were introduced to ameliorate this problem, initially with some caution because of potential complications and the lack of necessary equipment. The purpose of this paper was to show that the procedure is simple, effective and associated with few complications. Ninety-six patients (32 men, 64 women) with lymphoma (25), leukemia (28), metastatic breast cancer (28) or other malignant lesions (15) were referred for insertion of a Silastic permanent indwelling catheter into the superior vena cava. The catheter was inserted through a subclavian vein using a Cordis Vein Dilator Kit, itself introduced over a guide wire inserted initially under fluoroscopic control. Local sepsis at the insertion site occurred in 6 of the first 43 patients treated but in none of the remainder. Six catheters became thrombosed and required revision. There were no instances of bleeding, air embolism or pulmonary complications. Patient acceptance of this method of venous access was high compared with that for peripheral, repeated venepuncture.
由于多种原因，静脉化疗长期使用的增加导致了静脉通路问题，其中一个原因是所用药物的硬化作用。硅橡胶导管被引入以改善这一问题，最初由于潜在的并发症和缺乏必要设备而有所谨慎。本文的目的是表明该操作简单、有效且并发症少。96例患者（32例男性，64例女性）患有淋巴瘤（25例）、白血病（28例）、转移性乳腺癌（28例）或其他恶性病变（15例），被转诊来将硅橡胶永久性留置导管插入上腔静脉。使用Cordis静脉扩张器套件通过锁骨下静脉插入导管，该套件本身是在最初在荧光镜控制下插入的导丝上引入的。在前43例接受治疗的患者中有6例在插入部位发生局部感染，但其余患者均未发生。6根导管发生血栓形成，需要进行修复。没有出血、空气栓塞或肺部并发症的情况。与外周反复静脉穿刺相比，患者对这种静脉通路方法的接受度很高。
