34例肿瘤患者上臂完全植入式静脉输液港应用体会

Application of upper arm totally implantable venous access ports in 34 patients with tumor

目的探讨肿瘤科医护联合为患者植入上臂完全植入式输液港的安全性、可行性及临床使用效果。方法选择本科室2017年3月至2017年12月共34例需长期输液治疗的肿瘤患者为研究对象,男20例,女14例,中位年龄63(35~83)岁,由本科室医师和护士联合为患者置入上臂完全植入式输液港,记录植入成功率、并发症及患者临床使用满意情况。结果 34例患者均顺利完成上臂完全植入式输液港植入术,植入成功率100%。从消毒铺巾开始至缝皮结束,整个操作过程约40 min(30~60 min),所有患者手术过程顺利;术后有2例患者因原发病病程进展死亡,1例患者出现囊袋周围软组织感染,所有患者中无一例出现输液不畅、导管移位、港座翻转等其他并发症,并发症发生率2.94%(1/34)。结论上臂完全植入式输液港具有穿刺安全、手术时间短、术中术后并发症少,医护联合操作可行性高等优点,可一定程度上补充胸壁式输液港及PICC的一些限制及不足,是一个很好的临床应用选择。

Objective To investigate the safety, feasibility and clinical application effect of upper arm totally implantable venous access port (TIVAP) inserted by the combination of oncologists and nurses in patients with tumor. Methods A total of 34 patients, who needed long-term transfusion treatment, were included in this study with upper arm TIVAP from March 2017 and December 2017. There were 20 males and 14 females. The median age was 63 (35~83) years. Upper arm TIVAP was implanted by both doctors and nurses into the patients with tumor, and the TIVAP related success rate, complications and patients satisfaction were recorded. Results 34 patients all succeeded in TIVAP implantation with the operation success rate of 100%. The average operation time was about 40 minutes (30 to 60 minutes) from the disinfecting cloth to the end of the suture. The operations of all patients were successful. After the operation two patients died of cancer progression, one patient had soft tissue infection around capsular bag, None of the patients had other complications such as blocked infusion, catheter shift, port reversal, and so on, and the incidence of complication was 2.94%(1/34). Conclusions Upper arm TIVAP has the advantages of safe puncture, shorter operation time, few intra-operative and post-operative complications and higher feasibility for operation by both oncologist and nurse, which can supplement the limitations and deficiencies of the chest wall port and PICC in a certain extent, therefore is a good choice for clinical application.