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完全植入式静脉通路装置:一家采用多种技术方法的医院中发病率及危险因素的回顾性分析

Totally implantable venous access devices: A restrospective analysis of morbidity and risk factors in a hospital with multi-technique approaches.

作者信息

Melo-Pinto Diogo, Moreira-Marques Tatiana, Guerreiro Emanuel, Morais Marina

机构信息

Surgery Department, Hospital Pedro Hispano, R. de Dr. Eduardo Torres, Matosinhos, Senhora da Hora 4464-513, Portugal.

Surgery Department, Faculty of Medicine, University of Porto, Porto, Portugal.

出版信息

Surg Pract Sci. 2024 Feb 9;16:100237. doi: 10.1016/j.sipas.2024.100237. eCollection 2024 Mar.

Abstract

BACKGROUND

Totally implantable venous central access devices (TIVADs) can be implanted by open surgery or by direct puncture in the subclavian (ScV), internal jugular (IJV) or cephalic (CephV) veins.

METHODS

A retrospective study was conducted in 201 patients. Thirty-day follow-up data was analyzed to compare the outcomes of different techniques and evaluation of risk factors.

RESULTS

Complications were reported in 3.8 % of the patients with no overall differences between different vascular accesses. Direct puncture was associated with more accidental arterial punction ( = 0.01). History of previous catheters was a risk factor for immediate complications ( = 0.01) and patients with history of thoracic disease had more early and late complications ( = 0.03 and = 0.04, respectively). Late complications were more common in patients over 60 years old ( = 0.04) and with chronic pain ( = 0.03).

CONCLUSION

There was no difference in overall complication rates between the implantation techniques. Further prospective randomized controlled trials would clarify the most effective technique.

摘要

背景

完全植入式静脉中心血管通路装置(TIVADs)可通过开放手术或经锁骨下静脉(ScV)、颈内静脉(IJV)或头静脉(CephV)直接穿刺植入。

方法

对201例患者进行回顾性研究。分析30天随访数据,比较不同技术的结果并评估危险因素。

结果

3.8%的患者报告有并发症,不同血管通路之间无总体差异。直接穿刺与更多的意外动脉穿刺相关(P = 0.01)。既往有导管置入史是即刻并发症的危险因素(P = 0.01),有胸部疾病史的患者有更多的早期和晚期并发症(分别为P = 0.03和P = 0.04)。晚期并发症在60岁以上患者中更常见(P = 0.04)以及有慢性疼痛的患者中更常见(P = 0.03)。

结论

植入技术之间的总体并发症发生率无差异。进一步的前瞻性随机对照试验将阐明最有效的技术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d8f/11749897/b516cdcda413/gr1.jpg

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