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[乳腺癌化疗颈内静脉置管导管断裂8例]

[Eight Cases of Catheter Fracture in Internal Jugular Vein Ports for Breast Cancer Chemotherapy].

作者信息

Hasegawa Kei, Kitano Aya, Takamatsu Yuri, Udagawa Masaru, Watanabe Osamu

机构信息

Dept. of Breast Surgery, Sanwa Hospital.

出版信息

Gan To Kagaku Ryoho. 2022 Aug;49(8):887-889.

Abstract

Subcutaneous implantable venous ports were placed in 414 patients between April 2016 and August 2021 for the purpose of breast cancer chemotherapy in our hospital. Although the internal jugular vein approach was selected to prevent fractures caused by pinch-off syndrome, catheter fracture occurred in 8 patients(1.9%). All patients were ADL-independent women aged 44-62 years(median, 50.5 years). The intravenous ports were placed on the side of the dominant and non-dominant hands in 4 and 4 patients, respectively. Six patients received perioperative chemotherapy, while 2 had advanced breast cancer. Catheter fractures occurred 17.7-54.2 months(median, 41.7 months)after placement. The fractures were discovered when the patients presented with one or more of the following conditions: poor backflow of blood (n=4), subcutaneous emphysema observed on CT(n=1), subcutaneous leakage of CT contrast media(n=3), and no sign or symptom(n=1). The fractures occurred in the clavicular subcutaneous part in all patients. Partial and complete fractures of the catheter occurred in 5 and 3 patients, respectively. In 3 patients with complete fracture of the catheter, catheter tips had strayed into the right atrium and were removed using percutaneous endovascular procedures.

摘要

2016年4月至2021年8月期间,我院为414例乳腺癌化疗患者置入了皮下植入式静脉输液港。尽管选择颈内静脉入路以预防夹闭综合征导致的导管断裂,但仍有8例患者(1.9%)发生了导管断裂。所有患者均为日常生活活动自理的女性,年龄在44 - 62岁之间(中位年龄50.5岁)。静脉输液港分别在4例和4例患者的优势手侧和非优势手侧置入。6例患者接受了围手术期化疗,2例患有晚期乳腺癌。导管断裂发生在置入后17.7 - 54.2个月(中位时间41.7个月)。当患者出现以下一种或多种情况时发现导管断裂:回血不畅(n = 4)、CT检查发现皮下气肿(n = 1)、CT造影剂皮下渗漏(n = 3)以及无任何体征或症状(n = 1)。所有患者的导管断裂均发生在锁骨下皮下部分。导管部分断裂和完全断裂分别发生在5例和3例患者中。在3例导管完全断裂的患者中,导管尖端误入右心房,通过经皮血管腔内操作将其取出。

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