Freytes C O
Bone Marrow Transplant Program, University of Texas Health Science Center at San Antonio 78284-7880, USA.
Support Care Cancer. 1998 Jan;6(1):13-9. doi: 10.1007/s005200050126.
Despite the increased availability of vascular access devices, there is limited information regarding their pattern of use in the clinical setting or the criteria used for their utilization. To obtain this information, we sent questionnaires to MASCC members. Forty-five percent of the respondents stated that the decision to use vascular access devices depended on the drugs used at the beginning of therapy. Another 30% replied that the decision to use long-term vascular access devices depended on the status of the patient's veins at the beginning of therapy. Only 12% of those surveyed waited until all the veins were exhausted before considering using vascular access devices. Although more than half of the professionals surveyed used long-term vascular access devices in 50% or more of their patients with hematologic malignancies, only 20% used these devices in patients with solid tumors. Features considered most important when selecting long-term vascular access devices were durability of the device and ease of use for medical personnel. Major limitations of long-term vascular access devices were cost, closely followed by patient acceptance. The most common reasons for removal of vascular access devices were infection and thrombosis. We conclude that there is a lack of uniform criteria for the utilization of long-term vascular access devices. Cost is a major limitation to the wider use of this technology. More research is necessary to determine the optimal use of vascular access devices in patients with cancer.
尽管血管通路装置的可获得性有所增加，但关于其在临床环境中的使用模式或使用标准的信息却很有限。为了获取这些信息，我们向多支持性癌症护理协会（MASCC）的成员发送了调查问卷。45%的受访者表示，使用血管通路装置的决定取决于治疗开始时所使用的药物。另外30%的受访者回答说，使用长期血管通路装置的决定取决于治疗开始时患者的静脉状况。只有12%的受访者会等到所有静脉都无法使用后才考虑使用血管通路装置。尽管超过一半接受调查的专业人员在50%或更多的血液系统恶性肿瘤患者中使用了长期血管通路装置，但只有20%的人在实体瘤患者中使用这些装置。选择长期血管通路装置时认为最重要的特征是装置的耐用性和医护人员使用的便利性。长期血管通路装置的主要局限性是成本，紧随其后的是患者的接受度。移除血管通路装置最常见的原因是感染和血栓形成。我们得出结论，长期血管通路装置的使用缺乏统一标准。成本是这项技术更广泛应用的主要限制因素。需要进行更多研究以确定癌症患者血管通路装置的最佳使用方法。
