Koretsune Yuji, Sugawara Shunsuke, Sone Miyuki, Higashihara Hiroki, Arakawa Ayumu, Ogawa Chitose, Kusumoto Masahiko, Tomiyama Noriyuki
Diagnostic and Interventional Radiology, Osaka University, Osaka, JPN.
Diagnostic Radiology, National Cancer Center Hospital, Tokyo, JPN.
Cureus. 2024 Jun 25;16(6):e63106. doi: 10.7759/cureus.63106. eCollection 2024 Jun.
Background Although some reports have evaluated the safety and efficacy of central venous port (CVP) placement in pediatric patients, the data about the inversion rate of the device and its risk factors are scarce. Therefore, this study aimed to evaluate the inversion rates of CVPs and their associated risk factors in pediatric patients. Methodology Between January 2010 and December 2021, 154 consecutive children (75 boys; median age, 28.5 months; range, 2-71 months) who underwent CVP placement at our center were included in this study. The primary outcome was the CVP inversion rate, and the secondary outcomes included technical success rate, intraoperative complications, and infectious complications. Intraoperative complications were evaluated according to the Society of Interventional Radiology guidelines. Patients under two years old were classified as the younger group and those aged ≥two years as the older group. Results The CVP inversion rate was 4.6% (n = 7/153), equivalent to 0.08 × 1,000 catheter-days. The inversion rate was significantly higher in the younger group (under two years old, 11.2%) than in the older group (≥two years old, 1.0%) according to the univariate analysis (p = 0.00576). The technical success rate was 99.4% (n = 153/154), and mild adverse events were observed during the procedure in three (1.9%) patients. Infectious complications were observed in 16 (10.5%) patients, equivalent to 0.19 × 1,000 catheter-days. Conclusions The CVP inversion rate was significantly higher in younger children (under two years old) than in older children (≥two years old).
尽管一些报告评估了儿科患者中心静脉导管（CVP）置入的安全性和有效性，但关于该装置翻转率及其危险因素的数据却很稀少。因此，本研究旨在评估儿科患者CVP的翻转率及其相关危险因素。方法：2010年1月至2021年12月期间，在我们中心接受CVP置入的154例连续儿童（75例男孩；中位年龄28.5个月；范围2 - 71个月）纳入本研究。主要结局是CVP翻转率，次要结局包括技术成功率、术中并发症和感染性并发症。术中并发症根据介入放射学会指南进行评估。两岁以下的患者被分类为较年轻组，年龄≥两岁的患者为较年长组。结果：CVP翻转率为4.6%（n = 7/153），相当于每1000导管日0.08例。根据单因素分析，较年轻组（两岁以下，11.2%）的翻转率显著高于较年长组（≥两岁，1.0%）（p = 0.00576）。技术成功率为99.4%（n = 153/154），3例（1.9%）患者在手术过程中观察到轻度不良事件。16例（10.5%）患者观察到感染性并发症，相当于每1000导管日0.19例。结论：年幼儿童（两岁以下）的CVP翻转率显著高于年长儿童（≥两岁）。
