Horne M K, Mayo D J, Alexander H R, Steinhaus E P, Chang R C, Whitman E, Gralnick H R
Clinical Pathology Department, Warren G. Magnuson Clinical Center, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892.
Thromb Haemost. 1994 Oct;72(4):540-2.
Central venous access devices (VADs) are often associated with thrombotic obstruction of the axillary-subclavian venous system. To explore the accuracy of impedance plethysmography (IPG) in identifying this complication we performed IPG on 35 adult cancer patients before their VADs were placed and approximately 6 weeks later. At the time of the second IPG the patients also underwent contrast venography of the axillary-subclavian system. The venograms revealed partial venous obstruction in 12 patients (34%) and complete obstruction in two (5.7%). Although the IPG results from venographically normal and abnormal patients overlapped extensively, mean measurements of venous outflow were significantly lower in the patient population with abnormal venograms (P = 0.052 for Vo; P = 0.0036 for Vo/Vc). In our hands, therefore, upper extremity IPG cannot be used to make clinical decisions about individual patients with VADs, but it can distinguish venographically normal and abnormal populations.
中心静脉通路装置（VADs）常与腋-锁骨下静脉系统的血栓形成性阻塞相关。为探究阻抗体积描记法（IPG）在识别这一并发症方面的准确性，我们对35例成年癌症患者在植入VADs之前及大约6周后进行了IPG检查。在第二次IPG检查时，患者还接受了腋-锁骨下系统的静脉造影。静脉造影显示12例患者（34%）存在部分静脉阻塞，2例患者（5.7%）存在完全阻塞。尽管静脉造影正常和异常患者的IPG结果有大量重叠，但静脉造影异常的患者群体中静脉流出量的平均测量值显著更低（Vo的P = 0.052；Vo/Vc的P = 0.0036）。因此，在我们的研究中，上肢IPG不能用于对个体VADs患者做出临床决策，但它可以区分静脉造影正常和异常的人群。
