Krasnow S H, Rhodes G, Boyer M, Citron M L, Gaspar O, Johnston-Early A, Cohen M H
South Med J. 1985 Nov;78(11):1327-9. doi: 10.1097/00007611-198511000-00014.
In a series of 60 consecutive patients in whom Hickman catheters were placed for treatment of malignancy, four properly positioned catheter tips migrated secondarily from the superior vena cava to the ipsilateral jugular vein 2, 4, 21, and 25 days after placement. Three of the four patients had begun to have catheter dysfunction when the displacement was diagnosed. No satisfactory explanation for this rarely reported complication was evident in three of the cases. Maneuvers such as coughing, Valsalva's maneuver, and forceful heparin flushing produced no motion in three normally directed catheter tips in other patients observed under fluoroscopy. The phenomenon may be more common than previously reported. Evaluation of any new Hickman catheter dysfunction should include a chest x-ray film to ascertain the position of the catheter.
在一组连续60例因恶性肿瘤放置希克曼导管进行治疗的患者中，有4例导管尖端位置正确，但在放置后2天、4天、21天和25天从 Superior vena cava（上腔静脉） 继发迁移至同侧颈静脉。4例患者中有3例在诊断出移位时已开始出现导管功能障碍。在3例病例中，没有明显的令人满意的解释来说明这种罕见报道的并发症。在荧光透视下观察其他患者，咳嗽、瓦尔萨尔瓦动作和强力肝素冲洗等操作在3个正常方向的导管尖端未产生移动。这种现象可能比以前报道的更为常见。对任何新的希克曼导管功能障碍的评估都应包括胸部X光片以确定导管位置。
