Hoch J R
Department of Surgery, University of Wisconsin, Madison, USA.
Semin Vasc Surg. 1997 Sep;10(3):135-43.
The increasing use of permanent venous access devices and peripherally inserted central catheters has dramatically altered how we care for patients with a variety of illnesses. The development of complications either at the time of catheter insertion or with prolonged use may result in limited durability of the device, decreased cost-effectiveness, and significant patient morbidity or mortality. Our purpose is to review for the clinician the common complications associated with permanent venous access devices (PVADs) and peripherally inserted central catheters (PICCs). Most PVAD complications occurring at the time of catheter insertion can be avoided by returning to the venous cut-down technique. The most common cause for PVAD removal before the completion of therapy is catheter-related infection, whereas mechanical device failures result in most premature removals of PICCs. Catheter-related subclavian and axillary vein thromboses are not benign but are associated with up to a 12% incidence of pulmonary embolism. Future prospective investigations are needed to identify techniques to prevent, or better manage, the major long-term complications of PVADs and PICCs.
永久性静脉通路装置和外周静脉穿刺中心静脉导管的使用日益增加，极大地改变了我们对患有各种疾病患者的护理方式。在导管插入时或长期使用过程中出现的并发症，可能导致装置耐用性受限、成本效益降低以及患者出现严重的发病率或死亡率。我们的目的是为临床医生综述与永久性静脉通路装置（PVAD）和外周静脉穿刺中心静脉导管（PICC）相关的常见并发症。大多数在导管插入时发生的PVAD并发症可通过恢复静脉切开技术来避免。在治疗完成前拔除PVAD的最常见原因是导管相关感染，而机械装置故障则导致大多数PICC过早拔除。导管相关的锁骨下静脉和腋静脉血栓形成并非良性，且与高达12%的肺栓塞发生率相关。未来需要进行前瞻性研究，以确定预防或更好地管理PVAD和PICC主要长期并发症的技术。
