超声引导下经腋静脉植入输液港在乳腺癌化疗患者中的应用

Application of ultrasound guided axillary vein infusion port in breast cancer patients with chemotherapy and complications management

目的探讨超声引导下经腋静脉置入输液港在乳腺癌化疗患者中的应用及并发症处理。方法采用方便抽样方法．对重庆医科大学附属第一医院内分泌乳腺外科2016年9月至2017年1月的50例经腋静脉植入输液港的乳腺癌化疗患者进行分析研究。结果经超声引导下经腋静脉置入输液港穿刺置管成功率为98％（49／50）：手术时间（26±4）min。穿刺次数≤2次为96％（48／50）。术中常见并发症包括气胸发生率为0％（0／50）和误穿动脉发生率为4％（2／50），导管异位发生率为2％（1／50），术中出血2％（1／50）。术后远期并发症包括夹闭综合征发生率0％（0／50），血栓发生率2％（1／50），感染发生率为2％（1／50），导管脱落发生率0％（0／50）。结论植入式静脉输液港是临床需长期静脉输液的常用技术，经超声引导下腋静脉穿刺植入为一项安全、有效、并发症发生率相对较低的技术，有利于临床的开展。

Objective To explore the clinical application and complication management of ultrasound- guided implantation of venous access port via axillary vein in breast cancer patients with chemotherapy. Methods From Sep. 2016 to Jan. 2017, 50 breast cancer patients were implanted implantable venous access ports via the axillary vein under ultrasound guidance in the First Affiliated Hospital of Chongqing Medical University, among whom 25 cases with the left-side breast cancer, the other cases with right-side breast cancer. The effects of the application of implantation method and complication management were observed. Results The success rate of venous access ports via the axillary vein under ultrasound guidance was 98%（49/50）. The operation time was （26±4）mins. The number of puncture ≤ 2 times was 96%（48/50）. The incidence of intraoperative complications including pneu- mothorax （0%, 0/50） , error arterial puncture rate 4% （2/50）, catheter cctopic incidence 2% （1/50）, and intraoper- ative blood loss 2%（1/50）. The long-term postoperative included pinch-off syndrome （POS） （0%, 0/50） , throm- boembolism （2 %, 1/50）, infection （2%, 1/50） and catheter detachment （0%, 0/50）. Conclusion Ultrasound- guided implantation of venous access port via axillary vein has features of high success ratio, high safety, and low complication rate, which provides additional venous channel selection of port implantation.