Gyves J, Ensminger W, Niederhuber J, Liepman M, Cozzi E, Doan K, Dakhil S, Wheeler R
Am J Med. 1982 Dec;73(6):841-5. doi: 10.1016/0002-9343(82)90774-4.
A totally implanted system for improved central venous access has been investigated in 20 patients with cancer (six with solid tumors, four with leukemia, and 10 with lymphomas) who were treated with aggressive chemotherapy regimens and who lacked peripheral venous sites. The system is implanted using local anesthesia and consists of a subcutaneous injection port connected to a Silastic catheter threaded through the subclavian vein into the superior vena cava. Injections and continuous infusions (for up to three weeks) of virtually all classes of antineoplastic agents, antibiotics, blood components, and intravenous solutions were administered through the system. The system was filled with heparinized saline and not otherwise flushed between uses. The system has remained functional for periods exceeding 450 days (mean 235 days). There was no significant local irritation and no system became infected. None of 18 large-bore catheters (0.63 mm lumen) became occluded (seven to 300 days), whereas five of six small-bore catheters (0.38 mm lumen) became occluded (90 to 420 days). Three of the occluded systems were replaced. Acceptance has been excellent, and patients have had no impediment to normal activities. This system appears to be an alternate means of safe and reliable central venous access with improved convenience and cosmetic acceptability.
对20例癌症患者（6例实体瘤、4例白血病和10例淋巴瘤）进行了研究，这些患者接受积极的化疗方案治疗且缺乏外周静脉穿刺部位，研究了一种用于改善中心静脉通路的完全植入式系统。该系统采用局部麻醉植入，由一个皮下注射端口连接一根硅橡胶导管组成，导管经锁骨下静脉插入上腔静脉。几乎所有种类的抗肿瘤药物、抗生素、血液成分和静脉输液（长达三周）均通过该系统进行注射和持续输注。该系统用肝素化盐水填充，使用期间不进行其他冲洗。该系统已保持功能超过450天（平均235天）。没有明显的局部刺激，也没有系统发生感染。18根大口径导管（管腔0.63毫米）无一堵塞（7至300天），而6根小口径导管（管腔0.38毫米）中有5根堵塞（90至420天）。对3个堵塞的系统进行了更换。患者接受度极佳，对正常活动没有妨碍。该系统似乎是一种安全可靠的中心静脉通路的替代方法，具有更高的便利性和美观性。
