Strum S, McDermed J, Korn A, Joseph C
J Clin Oncol. 1986 Apr;4(4):596-603. doi: 10.1200/JCO.1986.4.4.596.
We prospectively evaluated the performance and rate of long-term complications with the Port-A-Cath (PAC), a totally implanted vascular access system. Two catheter styles were evaluated, a small-bore (SB) catheter (0.51-mm diameter) and a large-bore (LB) catheter (1.02-mm diameter), in conjunction with the use of a strict catheter care protocol. The PAC performed well, and with both SB and LB systems, no significant extravasation, skin necrosis, hematoma, septum damage or leakage, or subcutaneous portal infections occurred after 7,240 days of implantation and 1,435 days of use. Complications with the PAC system consisted of catheter occlusion (seven patients, 21.5%) and one instance of possible catheter infection (3.1%). Occlusions were limited to patients implanted with the SB catheter (seven of 16, 43.8%), and five of the seven (71.4%) occurred in patients receiving continuous infusion chemotherapy and/or total parenteral nutrition. Patency of the PAC system was maintained using a regular flushing schedule once every 30 days, a significant advantage compared with the daily maintenance schedule required with externally placed venous catheters. The results of this study suggest that the PAC system can provide a safe and reliable method for venous access in patients requiring intermittent or prolonged intravenous therapy.
我们前瞻性地评估了完全植入式血管通路系统Port-A-Cath（PAC）的性能及长期并发症发生率。我们评估了两种导管类型，一种是小口径（SB）导管（直径0.51毫米），另一种是大口径（LB）导管（直径1.02毫米），同时采用了严格的导管护理方案。PAC表现良好，在植入7240天和使用1435天后，无论是SB系统还是LB系统，均未发生明显的外渗、皮肤坏死、血肿、隔膜损伤或渗漏，也未发生皮下入口感染。PAC系统的并发症包括导管堵塞（7例患者，21.5%）和1例可能的导管感染（3.1%）。堵塞仅限于植入SB导管的患者（16例中的7例，43.8%），7例中有5例（71.4%）发生在接受持续输注化疗和/或全胃肠外营养的患者中。通过每30天进行一次定期冲洗的方案来维持PAC系统的通畅，与外置静脉导管所需的每日维护方案相比，这是一个显著的优势。本研究结果表明，PAC系统可为需要间歇性或长期静脉治疗的患者提供一种安全可靠的静脉通路方法。
