改良扩皮方式在手臂输液港患者中应用效果的研究

Efficacy of improved skin expanding method on patients with arm infusion port

目的探讨改良传统扩皮方式在手臂输液港植入术患者中应用的可行性及安全性。方法回顾性分析100例需行辅助化疗的妇科恶性肿瘤患者的临床资料,对照组50例采用传统的置管扩皮方式横切,可将插管鞘组件插入血管即可;50例观察组采取改良式扩皮方法,即沿导丝向港座方向倾斜45°切开深度及长度均为0.5 cm的切口。分析比较两组患者的植港时间、操作顺畅度、二次扩皮发生率、患者满意度、取港时间以及术后并发症发生率。结果观察组在植港时间、操作顺畅度、二次扩皮发生率、患者满意度、取港时间以及术后并发症发生率与对照组比较差异均有统计学意义(P<0.05)。结论与传统扩皮方式相比,改良式扩皮方式,便于调整连接港体时导致的导管挪动,可在切口处将导管回送血管,保持导管的顺畅度,使手术过程更流畅,整体提高上臂输液港植入术的效率。扩皮角度的改良有效避免了导管留置后,隧道内的导管及港座对于血管的骑跨而引发的不良后果,大大提高了患者在应用输液港期间的安全性。

Objective To explore the efficacy and safety of improved skin expanding method on patients with arm infusion port.Methods Clinical data of 100 patients with gynecological malignant tumor receiving adjuvant chemotherapy was retrospectively analyzed, including 50 patients treated by traditional way of expanding skin(transverse and micro intubation sheath inserted into blood vessels) and 50 patients treated by modified skin expanding method, namely making an incision with both depth and length of 0.5 cm which tilting 45° from the thread toward the port. The indexes as planting time, smooth operation, incidence of secondary enlargement, patient satisfaction, port moving time and incidence of postoperative complications were compared and analyzed between the two groups.Result Modified skin expanding method was superior to traditional skin expanding way in planting time, smooth operation, incidence of secondary enlargement, patient satisfaction, port moving time and incidence of postoperative complications.Conclusions Compared with the traditional way of expanding skin, modified skin expanding method can adjust catheter malposition caused by connecting with the port and send the catheter back into blood vessel at the incision maintaining the smooth of the catheter. Can make the operation well going increasing the efficiency of implantation of the upper arm infusion port. Can avoid the adverse consequences from the straddle of blood vessel by catheter and port in the tunnel after the catheter indwelling, which greatly enhances the safety of patients during infusion port application period.