Ray S, Stacey R, Imrie M, Filshie J
Anaesthetics, Royal Marsden Hospital, Sutton.
Anaesthesia. 1996 Oct;51(10):981-5. doi: 10.1111/j.1365-2044.1996.tb14972.x.
Indwelling, cuffed, tunnelled, central venous (Hickman) catheters are increasingly being used for venous access and the administration of chemotherapy for oncological patients. This paper reviews the technical problems associated with the percutaneous insertion of these catheters and the complications arising from their use. Five hundred and sixty catheters were inserted; 31.3% had complications at insertion, most commonly precipitation of an arrhythmia (13.9%). Arterial puncture occurred in 3.8% and pneumothorax in 1.6%. Catheters remained in place for a median period of 91 days. Forty percent of catheters were removed electively on completion of treatment; 30.2% required removal because of complications, which included sepsis, migration, thrombosis and blockage. Twenty percent of patients died with their catheter in place, 8.5% were still in situ and 1.6% were removed because of patient non compliance. Sepsis remains the commonest, long term complication, with staphylococcus epidermidis being the organism isolated most frequently. There were no catheter-related deaths.
留置式、带袖套、经隧道置入的中心静脉（希克曼）导管越来越多地用于肿瘤患者的静脉通路建立和化疗给药。本文综述了与这些导管经皮插入相关的技术问题及其使用引起的并发症。共插入了560根导管；31.3%在插入时出现并发症，最常见的是心律失常（13.9%）。动脉穿刺发生率为3.8%，气胸发生率为1.6%。导管留置的中位时间为91天。40%的导管在治疗结束时被选择性拔除；30.2%因并发症需要拔除，并发症包括败血症、移位、血栓形成和堵塞。20%的患者在导管留置期间死亡，8.5%的导管仍在位，1.6%因患者不配合而拔除。败血症仍然是最常见的长期并发症，表皮葡萄球菌是最常分离出的病原体。没有与导管相关的死亡病例。
