乳腺癌患者数字减影血管造影引导与超声实时引导植入静脉输液港的比较

Comparison of the implantable venous access port implantation guided by DSA and ultrasound

目的探讨数字减影血管造影(DSA)与超声实时引导下对乳腺癌患者植入静脉输液港的有效性和安全性。方法选取2013年7月至2015年7月间桂林市妇女儿童医院收治的79例乳腺癌患者,采用随机数表法分为两组,一组40例患者实施DSA引导下植入输液港(DSA组);另一组39例患者实施超声实时引导下植入输液港(超声组)。分别统计两组患者的一次置管成功率和置管相关并发症的发生率。结果 DSA组一次置管成功率为75.0%,低于超声组的100.0%,差异有统计学意义(P<0.01)。置管相关并发症中,DSA组12.5%的患者误伤动脉导致血肿,超声组无,差异有统计学意义(P<0.05)。DSA组患者对导管末端位置均满意,超声组患者中有3例导管末端位置不理想。结论与DSA引导下植入输液港比较,超声实时引导下植入穿刺成功率高,并发症出现率低,但DSA引导的导管末端放置准确性高。

Objective To compare the effectiveness and safety between digital subtraction angiog- raphy （DSA） and real-time ultrasound guided implantable venous access port （IVAP） implantation. Meth- ods Seventy-nine patients who underwent IVAP implantation at Guilin Maternal and Child Health Hospital from July 2013 to July 2015 were included. Patients were divided into DSA guided group （40 patients） and ultrasound guided group （39 patients）. The success rate of one-time catheterization and catheterization as- sociated complication were calculated. Results The success rate of one-time catheterization was 75.0% in DSA guided group which was lower than 100. 0% of ultrasound guided group （P 〈0.01）. For catheteriza- tion associated complication, hematomas caused by accidental arterial catheter occured in 12. 5% patients in DSA guided group and no inrury occurred in ultrasound guided group （ P 〉 0.05 ）. Conclusion Compared with DSA-guided IVAP implantation, ultrasound guided implantation leads to high puncture success rates and low incidence of complications. However, DSA-guided implantation has high accuracy of catheter tip placement.