172例乳腺癌输液港静脉血栓相关因素分析

Relative factors of catheter-related thrombosis in 172 breast cancer patients with implantable intravenous port

目的:通过对172例乳腺癌患者输液港临床资料回顾性总结,分析静脉血栓形成原因。方法:收集2013年11月至2014年12月就诊于重庆医科大学附属第一医院内分泌外科172例乳腺癌患者性别、年龄、港安置和肿瘤位置、化疗方案及局部静脉彩超等临床资料,分析静脉血栓形成的影响因素。结果:172例乳腺癌患者采用左颈内静脉或右颈内静脉置港化疗的人数分别为48和124例。共有42例(42/172,24.4%)患者发生静脉血栓,其中左颈内静脉16例(16/48,33.3%),右侧26例(26/124,21.0%),(P>0.05);化疗TEC/EC-T方案32例(32/42,76.2%),TAC方案5例(5/42,11.9%),CEF/FEC方案2例(2/42,4.8%),EC方案3例(3/42,7.1%),(P<0.001);化疗第1疗程2例(2/42,4.8%),化疗第2疗程5例(5/42,11.9%),第3、4、5、6疗程分别有9例(9/42,21.4%),12例(12/42,28.6%),8例(8/42,19.0%)和6例(6/42,14,3%)。结论:静脉血栓形成是输液港临床应用中较常见的并发症,颈内静脉左侧为好发部位,但无统计学差异(P>0.05)。化疗周期与静脉血栓形成的关系不大(P>0.05)。不同的化疗药物是引起静脉血栓形成的主要因素,TEC/EC-T方案最容易引起静脉血栓(P<0.001)。

Objective：To explore factors affecting port venous thrombosis in breast cancer patients. Methods：Data of 172 breast cancer patients admitted to the First Affiliated Hospital of Chongqing Medical University from November2013 to December 2014 were collected and analyzed in regard of gender,age,implantable sites,tumor location,chemotherapy regimens and colorful ultrasound results.Results：Catheter-related thrombosis occurred in 42 out of 172 patients（42/172,24.4%）with implantable intravenous port including16 cases（16/48,33.3%） of left side internal jugular vein,26 cases（26/124,21.0%） on the right side（P〈0.05）,32 cases（32/42,76.2%）with TEC/ECT scheme,5 cases（5/42,11.9%）with the TAC scheme,2 cases（2/42,4.8%）with CEF/FEC scheme,3 cases（3/42,7.1%）with EC scheme（P〈0.001）,5 cases（5/42,11.9%）in 2nd chemotherapy cycle,8 cases（8/42,19.0%）and 6 cases（6/42,14.3%）in 5th and 6th chemotherapy cycles,respectively（P〈0.05）. Conclusion：Catheter-related thrombosis is a common complication in breast cancer patients with implantable intravenous port and the left side is the predilection site. There is no correlation between venous thrombosis and chemotherapy cycles. Chemotherapy drugs may be responsible for formation of thrombosis and TEC/ECT regime is the most likely cause.