超声导引下上臂完全植入式输液港植入临床应用

发布时间：2019-04-28 15:27

【摘要】：目的探讨超声导引下上臂完全植入式输液港(TIAP)植入的安全性、技术可行性及相关并发症。方法选择2014年2月至2016年12月接受上臂植入TIAP患者642例,其中男407例(63.4%),女235例(36.6%),年龄11~89(58.29±4.33)岁。采用超声导引下Seldinger置管技术,于上臂植入TIAP。结果 642例患者均植入上臂TIAP,首次植入成功率99.53%(639/642),3例首次穿刺失败,第2次植入成功。随访155 302个导管日,共发生并发症58例(9.0%),其中近期并发症9例,远期并发症49例;TIAP相关感染28例(4.4%),导管静脉血栓7例(1.1%),囊袋出血3例(0.4%),TIAP体翻转3例(0.4%),皮肤裂开1例(0.2%),导管堵塞2例(0.3%),导管继发移位4例(0.6%),导管相关上肢运动受限7例(1.1%),上肢静脉回流障碍2例(0.3%),正中神经损伤1例(0.2%),无相关死亡事件发生。结论超声导引下经皮穿刺上臂植入TIAP技术安全有效,创伤小,并发症发生率低,值得临床推广应用。
[Abstract]:Objective to investigate the safety, technical feasibility and related complications of (TIAP) implantation in a fully implanted upper arm infusion port under ultrasound guidance. Methods from February 2014 to December 2016, 642 patients (male 407 (63.4%), female 235 (36.6%), age 11 / 89 (58.29 卤4.33) years) with upper arm implantation of TIAP were selected. Ultrasound-guided Seldinger tube placement technique was used to implant TIAP. into the upper arm. Results the success rate of the first implantation of upper arm TIAP, was 99.53% (639 / 642) in all the 642 patients. The first puncture failed in 3 cases and the second implantation was successful in 3 cases. During the follow-up of 155,302 catheter days, 58 cases (9.0%) had complications, including 9 cases of short-term complications and 49 cases of long-term complications. TIAP-associated infection was found in 28 cases (4.4%), catheter venous thrombosis in 7 cases (1.1%), cystic hemorrhage in 3 cases (0.4%), tip body reversal in 3 cases (0.4%), skin dehiscence in 1 case (0.2%). Catheter occlusion was found in 2 cases (0.3%), secondary catheter displacement in 4 cases (0.6%), catheter-related upper limb movement restriction in 7 cases (1.1%), venous reflux disorder in 2 cases (0.3%), and catheter-related upper limb movement restriction in 7 cases (1.1%). The median nerve injury occurred in 1 case (0.2%), and there was no related death event. Conclusion Percutaneous transhepatic TIAP implantation under ultrasound guidance is safe and effective with little trauma and low incidence of complications. It is worth popularizing and applying in clinical practice.
【作者单位】：上海交通大学医学院附属仁济医院肿瘤科;上海交通大学医学院附属仁济医院肿瘤介入科;
【基金】：上海市卫生计生委科研项目(20134092) 上海交通大学医学院科技基金(Jyh1609)
【分类号】：R472

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