Kock H J, Pietsch M, Krause U, Wilke H, Eigler F W
Department of Trauma Surgery, Rhinisch-Westfälische Technische Hochschule Aachen, Germany.
World J Surg. 1998 Jan;22(1):12-6. doi: 10.1007/s002689900342.
Totally implantable venous access systems are widely used, but large-scale studies evaluating these systems are lacking. In this study 1500 patients (719 male, 781 female) with an average age of 49 years (15-86 years) were fitted with subcutaneously implanted venous access systems, in most cases for long-term chemotherapy. All patients were observed until removal of the system, death, or the end of treatment. A retrospective analysis showed an average catheter life of 284 patient-days. A total of 1308 (87%) of the patients had no implant-related complications. Catheter infections occurred in 3.2% of the patients and catheter thromboses in 2.5%. Rarer complications, such as catheter malfunction, migration of the catheter, skin necrosis, catheter fracture, catheter disconnection, and pneumothorax, occurred in another 4.3% of the patients. The complications led to explantation of 178 access systems (11.9%). There was a significant difference (p < 0.05) between the low rate of infections and other complications in the group of patients with solid tumors (2% and 4%, respectively) and the rate in patients with hematologic diseases (6% and 8%, respectively). This study confirms the safety and convenience of using totally implantable venous access systems in patients on long-term chemotherapy.
全植入式静脉通路系统被广泛使用，但缺乏评估这些系统的大规模研究。在本研究中，1500例患者（719例男性，781例女性），平均年龄49岁（15 - 86岁），接受了皮下植入的静脉通路系统，大多数情况下用于长期化疗。所有患者均被观察至系统移除、死亡或治疗结束。回顾性分析显示，导管平均使用时长为284个患者日。共有1308例（87%）患者无植入相关并发症。3.2%的患者发生导管感染，2.5%的患者发生导管血栓形成。另外4.3%的患者发生了较罕见的并发症，如导管功能障碍、导管移位、皮肤坏死、导管断裂、导管断开连接和气胸。这些并发症导致178个通路系统（11.9%）被取出。实体瘤患者组的感染率和其他并发症发生率较低（分别为2%和4%），与血液系统疾病患者组的发生率（分别为6%和8%）之间存在显著差异（p < 0.05）。本研究证实了在长期化疗患者中使用全植入式静脉通路系统的安全性和便利性。
