超声引导下经颈内静脉输液港植入的临床应用

CLINICAL APPLICATION OF ULTRASOUND-GUIDED IMPLANTATION THROUGH THE INTERNAL JUGULAR VEIN INFUSION PORT

目的探讨超声引导静脉输液港植入(TIVAP)的临床应用特点。方法分析2018-06~2019-06内蒙古医科大学附属医院甲状腺乳腺外科实施的50例超声引导下植入TIVAP的病人临床资料(研究组)。同等条件下选取40例传统解剖定位静脉穿刺留置TIVAP的病人为对照组。对比研究2组病人的手术成功率、手术时间,穿刺准确度(穿刺次数≤2次的比例)以及术中、术后并发症的发生情况。结果超声引导下以及传统方式经颈内静脉放置 TIVAP均获得成功,成功率均为100%(50/50,40/40)。研究组病人手术时间稍短于对照组(36.8±11.6min 比44.5±16.9min,t=-1.463,P>0.05),差异无统计学意义。研究组的穿刺准确度(穿刺次数≤2次的比例),与对照组相比具有优势(49(98%)比32(80%),t=8.0,P<0.05),差异有统计学意义。2组病人术中及术后并发症发生率,二者相比,差异无统计学意义。结论超声引导下经颈内静脉穿刺植入TIVAP,对于该技术的迅速、安全、可靠推广具有一定的优势。

Objective:To investigate the clinical characteristics of ultrasound guided intravenous infusion port implantation(TIVAP).Methods:The clinical data of 50 patients(study group)who underwent ultrasound-guided TIVAP implantation in thyroid and breast surgery department of affiliated hospital of Inner Mongolia medical university from June 2018 to June 2019 were analyzed.Under the same condition,40 patients with TIVAP using traditional anatomic venipuncture were selected as the control group.The operative success rate,operative time,puncture accuracy(the proportion of puncture times ≤2)and intraoperative and postoperative complications were compared between the two groups.Results:Ultrasound guided and traditional placement of TIVAP via internal jugular vein was successful and the success rate was 100%(50/50,40/40).The operation time of the study group was slightly shorter than that of the control group(36.8±11.6min vs.44.5±16.9)min,t=-1.463,P>0.05),and the difference was not statistically significant.Compared with the control group,the puncture accuracy of the study group(proportion of puncture times ≤2)had an advantage(49(98%)vs.32(80%),t=8.0,P<0.05),and the difference was statistically significant.There was no significant difference in the incidence of intraoperative and postoperative complications between the two groups.Conclusion:Ultrasound-guided TIVAP implantation via internal jugular vein puncture has certain advantages for the rapid,safe and reliable promotion of the technology.