经右侧颈内与锁骨下静脉入路植入静脉输液港的比较研究

A Comparative Study of the Right Internal Jugular Vein and the Subclavian Vein Approach for Implantation of Intravenous Infusion

目的研究比较右侧颈内与锁骨下入路植入式静脉输液港可操作性和安全性,为临床植入式静脉输液港的入路选择提供参考。方法对我院自2008年6月至2010年9月220例输液港植入患者进行研究分析,其中右颈内入路组(A组)120例,锁骨下入路组(B组)100例。两组患者均在DSA引导下植入输液港,记录手术时间、并发症及临床使用情况。结果 A组115例顺利完成,置管成功率为95.8%,优于B组92%,差异有统计学意义(P<0.05);A组平均手术时间(36.5±2.2)min,明显短于B组(42.8±4.6)min,差异有统计学意义(P<0.05)。两组并发症的总发生率分别为14.2%和18.0%,差异无统计学意义(P>0.05)。B组输液港导管断裂的发生率(4%)明显高于A组(0),差异有统计学意义(P<0.05)。结论经右侧颈内静脉入路手术成功率高,手术时间短,严重并发症的发生率低于经锁骨下入路,应作为植入式静脉输液港置管的首选路径。

Objective To compare the operation and safety of the right internal jugular vein and the portal vein infusion port,and to provide a reference for the selection of the clinical placement.Methods 220 patients who received infusion port implant from June 2006 to September 2010 in our hospital were divided into right internal carotid approach group（ group A,120） and clavicle approach group（ group B,100）.Two groups of patients were implanted under the guidance of DSA port,and the operation time,complications and clinical use were recorded.Results In group A,115 cases were successfully completed,the success rate of intubation was 95. 8%,better than that of group B（ 92%,P〈0. 05）.The mean operation time of group A（ 36. 5±2. 2 min） wassignificantly shorter than that of group B（ 42. 8±4. 6 min）,the difference was statistically significant（ P〈0. 05）.The total incidence of complications in the two groups were 14. 2% and 18%,respectively,and the difference was not statistically significant（ P〈 0. 05）.The incidence rate of port catheter fracture in group B（ 4%） was significantly higher than that in group A（ 0）,and the difference was statistically significant（ P〈 0. 05）. Conclusion The right internal jugular vein approach has a higher successful rate,a shorter operation time,a lower serious complications incidence than that of the clavicle approach,thus it should be used as the first choice of implantable venous transfusion port.