Department of Outpatient Chemotherapy, Osaka International Cancer Institute, Japan.
Department of Diagnostic and Interventional Radiology, Osaka International Cancer Institute, Japan.
Intern Med. 2023 Oct 1;62(19):2827-2831. doi: 10.2169/internalmedicine.1249-22. Epub 2023 Feb 22.
Objective In routine practice, central venous ports without blood return (CVPWBRs) are common. However, very few studies have reported on the viable period of CVPWBR use. We therefore investigated this period by retrospectively analyzing the venographic images of CVPWBRs. Methods We examined patients' venography through the CVPs at the point when they became CVPWBRs for the first time and analyzed the reasons for becoming CVPWBRs. For patients with minor complications of CVPs or normal venographic findings, we used the Kaplan-Meier method to evaluate the period for which such CVPWBRs could be used. Patients Eighty-four patients with malignancy whose CVPs became CVPWBRs for the first time between July 31, 2015, and March 12, 2020, were included. Results Nine (10.7%) patients had major complications that made the CVPs unusable. Thirty-three (39.3%) patients had minor complications, and the remaining 42 (50.0%) had normal venographic findings. For the 75 patients with minor complications or normal venographic findings who continued to use their CVPWBRs, the Kaplan-Meier method estimated that 25% of complications that might make it unusable would occur within 1,273 days. Conclusion There are two learning points in our study. First, venography is needed when the CVP becomes a CVPWBR for the first time due to the high risk, and second, CVPWBRs can be used for a relatively long period in patients without major complications. It is necessary to develop an appropriate follow-up management method for CVPWBRs in prospective studies.
目的
在常规实践中,经常会遇到无回血中心静脉导管(CVPWBR)的情况。然而,很少有研究报告 CVPWBR 使用的可行时间。因此,我们通过回顾性分析 CVPWBR 的静脉造影图像来研究这一时期。
方法
我们检查了首次出现 CVPWBR 时患者的 CVP 静脉造影,并分析了成为 CVPWBR 的原因。对于 CVP 有轻微并发症或静脉造影正常的患者,我们使用 Kaplan-Meier 方法评估这些 CVPWBR 可使用的时间。
患者
纳入 2015 年 7 月 31 日至 2020 年 3 月 12 日期间首次出现 CVPWBR 的 84 例恶性肿瘤患者。
结果
9 例(10.7%)患者有严重并发症导致 CVP 无法使用。33 例(39.3%)患者有轻微并发症,其余 42 例(50.0%)静脉造影正常。对于 75 例有轻微并发症或静脉造影正常的继续使用 CVPWBR 的患者,Kaplan-Meier 方法估计,在 1273 天内,有 25%的并发症可能使其无法使用。
结论
我们的研究有两个学习要点。首先,由于风险较高,当 CVP 首次因某种原因成为 CVPWBR 时,需要进行静脉造影;其次,在没有严重并发症的情况下,CVPWBR 可以相对较长时间使用。在前瞻性研究中,有必要为 CVPWBR 制定适当的随访管理方法。