Muscedere G, Bennett J D, Lee T Y, Mackie I, Vanderburgh L
Department of Diagnostic Radiology, St. Joseph's Health Centre, London, Ont.
Can Assoc Radiol J. 1998 Apr;49(2):84-9.
To determine any differences in the complications following radiologic placement of 2 devices--Hickman catheters and central venous ports--to permit long-term central venous access in patients with AIDS.
Thirty-eight patients with AIDS received 52 long-term central venous access catheters. Seventeen received 23 Hickman catheters and 27 received 29 central venous ports (hence, 6 patients received both). Complications rates were determined retrospectively from clinical records and radiologic studies.
The only acute complications were pneumothoraces--3 in the patients receiving Hickman catheters and 2 in the patients receiving central venous ports. Infections developed in 12 of the patients receiving Hickman catheters a median of 53 and a mean of 96 days after placement. Infection developed in 8 of the patients receiving central venous ports a median of 125 days and a mean of 184 days after placement. This difference was statistically significant (p < 0.001). The most common organism in these infections was Staphylococcus aureus. The only other nonacute complication was 1 nonocclusive thrombosis of the superior vena cava, which occurred in a patient with a Hickman catheter 240 days after placement and resolved once the catheter was removed.
Central venous ports are preferred over Hickman catheters for long-term central venous access in patients with AIDS.
确定用于为艾滋病患者提供长期中心静脉通路的两种装置——希克曼导管和中心静脉端口——在放射学放置后并发症方面的差异。
38例艾滋病患者接受了52根长期中心静脉通路导管。17例患者接受了23根希克曼导管，27例患者接受了29个中心静脉端口（因此，6例患者同时接受了两者）。通过临床记录和放射学研究回顾性确定并发症发生率。
仅有的急性并发症是气胸——接受希克曼导管的患者中有3例，接受中心静脉端口的患者中有2例。接受希克曼导管的患者中有12例发生感染，放置后中位时间为53天，平均时间为96天。接受中心静脉端口的患者中有8例发生感染，放置后中位时间为125天，平均时间为184天。这种差异具有统计学意义（p < 0.001）。这些感染中最常见的病原体是金黄色葡萄球菌。唯一的其他非急性并发症是1例上腔静脉非闭塞性血栓形成，发生在1例接受希克曼导管的患者中，放置后240天出现，导管拔除后缓解。
对于艾滋病患者的长期中心静脉通路，中心静脉端口优于希克曼导管。
