Moral A, Targarona E M, Mallolas J, Martínez J, Pros I, Valverde M, Palombo H, Trias M
Servicio de Cirugía, Hospital Clínic i Provincial, Barcelona.
Enferm Infecc Microbiol Clin. 1993 Apr;11(4):190-4.
Chronic venous access may constitute a serious problem in some patients and the subcutaneous venous reservoirs have demonstrated to be a useful alternative. AIDS patients require intense pharmacologic treatment, thus the use of subcutaneous venous reservoirs may be specially useful. However, the prevalence of septic type complications following placement of the subcutaneous venous reservoirs in these patients is particularly high.
To know the efficacy of subcutaneous venous reservoirs in the AIDS population and compare the results in a non AIDS population.
All the subcutaneous venous reservoirs placed between January 1990 and December 1992 were prospectively studied with two groups being established: Group I: patients with positive serology for HIV and who achieved criteria of AIDS requiring placement of a subcutaneous venous reservoirs. Group II: All the remaining patients in whom a subcutaneous venous reservoirs was placed during the same period of time.
The incidence of infection was higher in group I (AIDS) with respect to group II (0.1 versus 0.014 infections/100 catheters/day, p < 0.01) and the non septic complications were higher in group II (3.6% versus 12.7%, p < 0.0004). The catheters were most frequently used in group I with respect to group II (12.7 +/- 7.1 versus 3.3 +/- 4.9 punctures/month) but the period was use longer in group II (13.7 +/- 9.2 versus 4.3 +/- 3.1 months, p < 0.0001).
The population of AIDS patients may benefit greatly from the systematic use of subcutaneous venous reservoir due to their clinical and therapeutic characteristics. Nonetheless greater risk of infection may occur in these patients because of the greater need for punctures with respect to the other indications for placement of these catheters.
长期静脉通路在某些患者中可能构成严重问题，皮下静脉储器已被证明是一种有用的替代方法。艾滋病患者需要强化药物治疗，因此皮下静脉储器的使用可能特别有用。然而，在这些患者中放置皮下静脉储器后发生感染性并发症的发生率特别高。
了解皮下静脉储器在艾滋病患者中的疗效，并与非艾滋病患者群体的结果进行比较。
对1990年1月至1992年12月期间放置的所有皮下静脉储器进行前瞻性研究，分为两组：第一组：HIV血清学阳性且符合艾滋病标准需要放置皮下静脉储器的患者。第二组：同期放置皮下静脉储器的所有其他患者。
第一组（艾滋病患者）的感染发生率高于第二组（0.1比0.014次感染/100导管/天，p<0.01），非感染性并发症在第二组更高（3.6%比12.7%，p<0.0004）。与第二组相比，第一组导管使用频率更高（12.7±7.1比3.3±4.9次穿刺/月），但第二组使用时间更长（13.7±9.2比4.3±3.1个月，p<0.0001）。
由于其临床和治疗特点，艾滋病患者群体可能从皮下静脉储器的系统使用中受益匪浅。然而，由于与放置这些导管的其他适应症相比，这些患者穿刺需求更大，可能会有更高的感染风险。
