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长期中心静脉外周通路系统端口(PAS端口)的放射学放置:150例患者的结果

Radiologic placement of long-term central venous peripheral access system ports (PAS Port): results in 150 patients.

作者信息

Foley M J

机构信息

Sheer Ahearn and Associates, Tampa, FL 33637, USA.

出版信息

J Vasc Interv Radiol. 1995 Mar-Apr;6(2):255-62. doi: 10.1016/s1051-0443(95)71109-5.

Abstract

PURPOSE

The author reports experience with 150 peripheral access system ports (PAS Ports) placed in an interventional radiology suite. Complication rates from this series are compared with those of surgically placed tunneled catheters. The average cost of placement is compared with that of a surgically placed chest port.

PATIENTS AND METHODS

Findings were retrospectively reviewed in 150 patients in whom the PAS Port catheter was implanted. The age range was 26-84 years (mean, 46 years). The diagnoses in these patients included cancer (n = 68), acquired immunodeficiency syndrome (n = 52), osteomyelitis (n = 21), and abscess (n = 9). Implantation with use of fluoroscopic guidance and "Cath-finder" technology is described.

RESULTS

One hundred fifty ports have been indwelling for a total of 24,151 patient days (range, 40-220 days; mean duration, 161 days). Sepsis occurred in 3.3%, local infection in 5% (early infection 1%, late infection 4%), temporary catheter occlusion in 3.3%, postinsertion phlebitis in 7.3%, and venous thrombosis in 2%. The cost of radiologic PAS Port insertion averaged $1,488 versus $3,720 for surgical chest port insertion.

CONCLUSION

PAS Port central venous catheter placement by an interventional radiologist in this series is safe and cost effective and compares very favorably with surgery. Radiologists will likely see increasing requests by referring physicians for radiologically placed catheters and ports in this era of cost containment.

摘要

目的

作者报告了在介入放射科套件中放置150个外周血管通路系统端口(PAS端口)的经验。将该系列的并发症发生率与手术放置的隧道式导管的并发症发生率进行比较。将放置的平均成本与手术放置的胸部端口的成本进行比较。

患者与方法

对150例植入PAS端口导管的患者的结果进行回顾性分析。年龄范围为26 - 84岁(平均46岁)。这些患者的诊断包括癌症(n = 68)、获得性免疫缺陷综合征(n = 52)、骨髓炎(n = 21)和脓肿(n = 9)。描述了在荧光透视引导和“导管定位器”技术下的植入过程。

结果

150个端口共留置了24151个患者日(范围为40 - 220天;平均持续时间为161天)。脓毒症发生率为3.3%,局部感染率为5%(早期感染1%,晚期感染4%),临时导管阻塞率为3.3%,插入后静脉炎发生率为7.3%,静脉血栓形成率为2%。放射学放置PAS端口的平均成本为1488美元,而手术放置胸部端口的成本为3720美元。

结论

在本系列中,介入放射科医生放置PAS端口中心静脉导管是安全且具有成本效益的,与手术相比非常有利。在这个成本控制的时代,放射科医生可能会看到转诊医生对放射学放置的导管和端口的需求不断增加。

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