立位时静脉输液港港体位置变化及影响因素分析

The changing of port body position of TIAP in patient’s erect position and analysis of its influencing factors

目的研究立位时经颈内静脉植入式输液港港体位置的变化,分析其影响因素。方法收集2017年1月至2018年4月间苏州大学附属第一医院行经颈内静脉植入胸壁式输液港患者86例。所有患者均经术中透视确定导管位置,记录每例患者平卧位和立位时锁骨上缘至囊袋切口距离及身高、体重、体质指数为(BMI)等数据,研究立位时港体位置变化及影响因素。结果经颈内静脉植入输液港立位时港体位置会产生下移,总体平均下移距离为(1.50±0.74)cm;男性与女性、左侧与右侧位置下移距离差异无统计学意义(P值分别为0.635、0.211);下移距离与患者BMI呈正相关(r=0.402,P<0.01)。结论胸壁式静脉输液港港体位置在立位时向下移动,且患者BMI越大下移越明显。经颈内静脉植入输液港时,应根据患者体型适当多预留部分导管长度。

Objective To study the changing of port body position of totally implantable access port(TIAP)implanted via jugular vein when the patient turns to erect position,and to analyze its influencing factors.Methods A total of 86 patients,who received implantation of chest wall TIAP via internal jugular vein during the period from January 2017 to April 2018 at the First Affiliated Hospital of Soochow University of China,were enrolled in this study.The position of catheter was determined by intraoperative fluoroscopy in all patients.The distances from the superior edge of clavicle to the skin incision in both supine position and erect position of each patient were measured,and the patient’s data such as height,weight,body mass index(BMI),etc.were recorded.The changing of port body position in patient’s erect position was documented and the influencing factors were analyzed.Results In patient’s erect position,the position of the port body of TIAP implanted via internal jugular vein would move downward,the average downward moving distance was(1.50±0.74)cm.No statistically significant differences in downward moving distance existed between males and females,as well as between left side and right side(P=0.653 and P=0.211,respectively).The downward moving distance bore a positive relationship to the patient’s BMI(r=0.402,P<0.01).Conclusion The position of the port body of chest TIAP will move downward when the patient turns to erect position.The larger the patient’s BMI is,the more obvious the downward moving distance will be.When TIAP is implanted via the internal jugular vein,sufficient length of the catheter should be reserved according to patient’s body type.