右锁骨下静脉药盒导管系统置入术的临床应用

The Clinical Application of Right Subclavian Venous Port-A-Catheter System Implantation

目的探讨右锁骨下静脉药盒导管置入术的并发症，评价其临床价值。资料与方法85例患者在透视下行右锁骨下静脉药盒导管系统置入术，记录并发症的发生及临床应用情况。结果83例患者成功完成右锁骨下静脉药盒导管系统置入术，手术成功率为97．65％（83／85）；操作时间为30～60min，平均45min；2例手术失败，其中1例气胸，1例穿刺锁骨下动脉；3例（3．52％）出现感染；2例（2．35％）化疗药外溢致局部皮肤坏死；5例（5．88％）导管堵塞；皮肤切口延迟愈合4例（4．70％）。使用该装置的患者感觉在输液治疗中的舒适程度高于其他静脉输注方式。结论右锁骨下静脉药盒导管置入术安全、便捷、并发症少，能够提高需要长期输液治疗患者的生活质量。

Objective To investigate the complications of right subclavian venous Port-A-Catheter system implantation and to evaluate the clinical application value of this system. Materials and Methods Between March 2002 and April 2007, 85 right subclavian venous Port-A-Catheter System were placed under fluoroscopy guidance, the complications and clinical application were collected and analyzed. Results 83 ports were successful implanted, the operation achivement rate was 97.65% （ 83/85 ）. The mean operation time was 45 minutes （ range, 30-60 mins）. In 2 patients , pereutaneous subclavianvein was not achieved due to pneumothorax in one patient and subclavian arterial punctured in the other patient. Other complications included pocket infection （3 patients, 3.52% ）, necrosis of skin （ 2 patients ,2.35% ）, aatheter occlusion （5 patients ,5.88% ） and delayed insicion healing （ 4 patients, 4.70% ）. Patients with this system felt more comfortable during intravenous infusion. Conclusion Right subclavian venous Port-A-Catheter system Implantation is an easy, safe and effective technique to improve the life quality, who require prolonged intravenous infusion treatment.