上腔静脉置管后皮下埋藏导管药盒与普通上腔静脉置管方法的临床对比观察

A comparative study of superior vena cava catherization with subcutaneous Port-Cath and the conventional superior vena cava catherization

目的对比上腔静脉置管后皮下埋藏导管药盒（Port-Cath）与普通上腔静脉置管方法的方便性和并发症的临床观察。方法选择40例病人分为两组，A组病人经锁骨下静脉穿刺上腔静脉置管后皮下埋藏带导管药盒（Port－Cath），B组病人经锁骨下静脉穿刺上腔静脉置双腔导管。结果Port－Cath组患者发生皮下血肿2例（占10％），导管堵塞4例（占20％），导管与Por连接处脱开1例（占5％）。B组患者发生导管堵塞1例（占5％），导管移位1例（占5％），两组无感染并发症发生。A组保留时间在30～790天（平均166天），B组置管保留时间在15～90天（平均22天），两组之间有统计学上显著性差异（P＜0．05）。两组均无气、血胸并发症发生。结论传统上腔静脉置管方法操作简便、并发症少，适用于需中心静脉置管2周至3个月的患者使用，而Port－Cath具有放置时间长，不影响日常生活等特点，更适合于需中心静脉置管3～6个月以上的晚期肿瘤患者化疗及输液治疗使用。

Objective To evaluate the clinical use of superior vena cava catheterization with subcutaneous PortCath and the conventional method of superior vena cava catheterization.Methods 40 patients were randomized into 2 groups: the A group in which superior vena cava catheterization with a subcutaneous Port-Cath was performed and the B group,the conventional technique of seperior vena cave catheterization with a doublechannel catheter.Results In the Port-Cath A group,there were 2 cases (10%) of subcutaneous hematoma,occlusion of the catheter in 4 (20% ), disconection of the catheter and the port in 1 (5 % ). In the B group,occlusion of the catheter was noted in 1 case (5 % ) and dislocation of the catheter in another (5%). No infection or sepsis was noted in both A and B group neither pneumothorax or hemothorax.In A group,the catheter was maitained for 30 ~ 790 days with an average of 166 days and in B group for 15 ~90 days with an average of 22 days.Conclusions The conventional technique of superior vena cava catheterization is easier to accomplish and leads to fewer complication,being indicated for patients needing 2 weeks to 3 months of central vein catheterization.The subcutaneous Port-Cath technique allows the catheter to stay much longer and may not influence the ordinary activities and is indicated for central vein catheterization more than 3~6 months especially for the late cancer patients.