Zhonghua Zhong Liu Za Zhi. 2024 Jun 23;46(6):517-525. doi: 10.3760/cma.j.cn112152-20231217-00364.
As one of a major public health issue in China, the number of new cases and deaths of malignant tumors has been climbing year by year. Implantable venous access port (IVAP) is used as a safe infusion route in the treatment of malignant tumor patients such as infusion of antitumor drugs and intravenous nutrition. With the widespread application of ultrasound-guided Sedinger puncture techniques and intracardiac electrocardiogram positioning technology, IVAP in the upper arm has been recognized by the majority of medical personnel and cancer patients due to its advantages of hiding scars and completely avoiding the risk of hemothorax and pneumothorax. In order to standardize the clinical application of IVAP via the upper arm approach in cancer patients, improve the success rate of implantation, reduce complications and improve patient satisfaction, the Breast Cancer Expert Committee of the National Cancer Quality Control Center consulted guidelines and the latest evidence-based evidences and established the expert consensus on the whole-course management of implantable venous access port in the upper arm of cancer patients through literature research and expert discussions, in order to provide reference for the standard application of IVAP in the upper arm. The consensus mainly introduces the indications, contraindications, preoperative evaluation, implantation site, operation procedure, utilization and maintenance, complications and management, medical staff training and patient education of IVAP in the upper arm, in order to provide reference for clinical staff.
作为中国主要的公共卫生问题之一,恶性肿瘤的新发病例数和死亡数逐年攀升。可植入式静脉输液港(IVAP)作为一种安全的输液途径,用于肿瘤患者的抗肿瘤药物输注、静脉营养等治疗。随着超声引导下塞丁格穿刺技术和心腔内心电图定位技术的广泛应用,上臂IVAP因其具有隐蔽瘢痕、完全避免血胸和气胸风险等优点,已被广大医务人员和癌症患者所认可。为规范癌症患者上臂途径IVAP的临床应用,提高植入成功率,减少并发症,提高患者满意度,国家癌症质量控制中心乳腺癌专家委员会查阅指南及最新循证依据,通过文献研究和专家讨论,制定了癌症患者上臂可植入式静脉输液港全程管理专家共识,为上臂IVAP的规范应用提供参考。该共识主要介绍了上臂IVAP的适应证、禁忌证、术前评估、植入部位、操作步骤、使用与维护、并发症及处理、医务人员培训和患者教育等内容,供临床工作人员参考。