DSA引导下植入式静脉输液港在恶性肿瘤患者中的应用

发布时间：2018-08-10 17:24

【摘要】：目的探讨DSA引导下植入式静脉输液港在恶性肿瘤患者中的应用。方法随访分析2013年4月—2016年3月在DSA引导下植入静脉输液港的恶性肿瘤患者的病例资料,观察并记录输液港植入的过程、并发症的发生及处理方法。结果 83例恶性肿瘤患者完成静脉输液港植入术,其中经锁骨下静脉入路75例,右颈内静脉入路7例,右股静脉入路1例。操作成功率100%,其中一次性静脉穿刺成功率为93.98%(78/83)。围手术期并发症的发生率为1.20%(1/83),表现为输液不畅。远期并发症的发生率为7.23%(6/83),包括术后局部皮肤感染1例,发生在术后第10个月,经抗感染治疗后治愈;导管血栓形成1例,发生在术后第8个月,经抗凝处理后取出输液港;导管堵塞1例,证实纤维蛋白鞘形成,经尿激酶处理无效后取出输液港;导管夹闭综合征3例,其中1例在术后第22个月导管断裂进入左肺动脉,通过抓捕器经右股静脉入路取出,1例在术后16个月因输液后肩膀酸痛拆除输液港,1例患者表现为输液不畅,植入输液港后6个月死于晚期肺癌。结论 DSA引导下植入静脉输液港操作简单、可视、定位准确,并发症少,可为恶性肿瘤提供长期、安全、方便的静脉通道,值得临床推广。
[Abstract]:Objective to investigate the application of DSA-guided intravenous infusion port in patients with malignant tumor. Methods the data of patients with malignant tumor implanted into venous infusion port under the guidance of DSA from April 2013 to March 2016 were analyzed. The procedure of implantation, the occurrence and treatment of complications were observed and recorded. Results Eighty-three patients with malignant tumor underwent intravenous infusion port implantation, including 75 patients via subclavian vein approach, 7 patients with right internal jugular vein approach and 1 patient with right femoral vein approach. The successful rate of operation was 100, in which the success rate of single venipuncture was 93.98% (78 / 83). The incidence of perioperative complications was 1.20% (1 / 83). The incidence of long-term complications was 7.23% (6 / 83), including 1 case of postoperative local skin infection, which occurred 10 months after operation and cured after anti-infection treatment, 1 case of catheter thrombosis occurred at the 8th month after operation, and the transfusion port was removed after anticoagulant treatment. Catheter blockage was confirmed in 1 case, fibrin sheath formation was confirmed, infusion port was removed after ineffective urokinase treatment, catheter clipping syndrome was found in 3 cases, in which 1 case ruptured into the left pulmonary artery 22 months after operation. After 16 months of operation, one patient with the right femoral vein was removed from the port of infusion because of shoulder soreness. One patient showed that the transfusion was not smooth and died of advanced lung cancer 6 months after the implantation of infusion port. Conclusion the DSA guided intravenous infusion port is simple, visual, accurate, and has few complications. It can provide long-term, safe and convenient venous passage for malignant tumor. It is worth popularizing in clinic.
【作者单位】：福建省肿瘤医院介入治疗科;
【基金】：福建省卫生计生委青年科研课题(2014-2-7) 国家临床重点专科建设项目(2013)
【分类号】：R473.73

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