乳腺癌化疗患者输液港导管周围附壁血栓形成的探讨

发布时间：2018-05-01 11:38

本文选题：乳腺癌 + 完全植入式静脉输液港　；参考：《上海交通大学学报(医学版)》2017年04期

【摘要】：目的·探讨乳腺癌患者使用完全植入式静脉输液港(TIVAP)化疗后导管相关附壁血栓形成的发生、危险因素及其治疗情况。方法·190例留置TIVAP化疗的乳腺癌患者,每疗程化疗前及取输液港前行颈部血管彩色超声检查,观察导管相关血栓形成的发生率、发生时间、危险因素及治疗结果。结果·190例患者中,112例(58.9%)发生导管相关附壁血栓形成;其中无症状血栓形成108例(占56.8%),症状性血栓形成4例(占2.1%)。置管后21 d时,输液港导管相关附壁血栓形成的发生率(22.1%)最高。年龄60岁的患者、乳腺癌临床分期为III~IV级者以及TEC(多西紫杉醇联合表阿霉素和环磷酰胺同期化疗)化疗方案是输液港导管相关血栓形成的危险因素。经皮下注射低分子肝素、口服蚓激酶肠溶胶囊或继续口服阿司匹林的患者,血栓消失率的差异无统计学意义(P=0.743)。结论·乳腺癌化疗患者使用输液港导管相关症状性血栓发生率较低,但无症状性血栓形成的发生率较高,应给予重视。年龄、肿瘤分期和TEC化疗方案是输液港导管周围附壁血栓形成的危险因素。
[Abstract]:Objective to investigate the incidence, risk factors and treatment of catheter-associated mural thrombus in breast cancer patients treated with TIVAP. Methods 190 patients with breast cancer treated with TIVAP were examined by color ultrasound before chemotherapy and before the infusion port. The incidence, time, risk factors and treatment results of catheter-related thrombosis were observed. Results among the 190 patients, 112 cases (58.9%) developed catheter-related mural thrombosis, of which 108 cases were asymptomatic thrombosis (56.8%) and 4 cases were symptomatic thrombosis (2.1%). 21 days after catheterization, the incidence of thrombus associated with catheterization was the highest (22. 1%). In patients aged 60 years, breast cancer patients with clinical stages of III~IV and Tac (docetaxel combined with epirubicin and cyclophosphamide chemotherapy) were risk factors of thromboembolism associated with infusion port ducts. There was no significant difference in thrombus disappearance rate in patients with subcutaneous injection of low molecular weight heparin (LMWH), oral wormkinase enteric-coated capsule (LKEC) or continuous oral aspirin (Aspirin). Conclusion the incidence of symptomatic thrombus associated with infusion conduit in breast cancer patients with chemotherapy is lower, but the incidence of asymptomatic thrombosis is higher. Age, tumor staging and TEC regimen were risk factors for thromboembolism around the catheter.
【作者单位】：重庆医科大学附属第一医院内分泌乳腺外科;
【基金】：重庆市科学技术委员会基金(cstc2016shmszx0323)~~
【分类号】：R737.9

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