经左右颈内静脉置入胸壁静脉输液港1595例的并发症特点分析

Analysis on the Complications of 1595 Cases of Chest-Wall Intravenous Infusion Port Through Left and Right Internal Jugular Veins

目的分析经左右颈内静脉置入胸壁港的术中及术后并发症发生特点,为临床选择穿刺静脉及预防并发症的发生提供相关参考。方法回顾性分析2017年至2019年我院安置的经左右颈内静脉置入的胸壁输液港的术中及术后不同类型并发症发生情况,并进行比较。结果左侧颈内静脉置入输液港676例,右侧颈内静脉置入输液港919例,左侧发生并发症43例,右侧发生并发症36例,其中穿刺期间送管不顺并发症左侧发生12例,右侧未发生,导管尖端异位左侧发生13例,右侧发生1例,术后使用期间导管颈部成角左侧发生6例,右侧未发生,左右两侧并发症发生率差异有统计学意义(P<0.05)。术后输液港相关血栓左侧发生2例,右侧发生8例,其中输液港相关血流感染左侧发生5例,右侧发生8例,该并发症两侧发生率差异无统计学意义(P>0.05)。结论左右两侧颈内静脉置入输液港并发症发生率有差别,左侧并发症发生率高于右侧,穿刺期间并发症如导管送管不顺、导管尖端异位、使用期间颈部导管成角导致无法输注液体的这三类并发症左侧发生率明显高于右侧,提示输液港置入术首选右侧,若选择左侧置入输液港,术中需加强针对性的预防措施,避免人为因素增加并发症的发生率。

Objective To analyze the characteristics of intraoperative and postoperative complications placed into chest wall port through the left and right internal jugular veins,which could provide relevant reference for clinical selection of vein puncture and prevention of complications.Methods From 2017 to 2019,intraoperative and postoperative complications of different types placed into chest wall port through the left and right internal jugular veins in our hospital were retrospectively analyzed and compared.Results Internal jugular vein inserted into the left had 676 cases,and the right had 919 cases.There were 43 complications on the left,36 complications on the right.During puncture,delivery failure occurred on the left had 12cases,and on the right had none.Ectopic catheter tip occurred on the left had 13 cases,and on the right had 1 case.During postoperative use,catheter neck angulation occurred on the left had 6 cases,and on the right had none.The difference of complications incidence between the left and right was statistically significant(P<0.05).Postoperative infusion port related thrombosis occurred on the left had 2 cases,and on the right had 8 cases.Infusion port related bloodstream infection occurred on the left had 5 cases,and on the right had 8 cases.There was no significant difference in complication incidence on both sides(P>0.05).Conclusion There is a difference in complications incidence between the left and right of internal jugular vein implantation port.The incidence of complications on the left is higher than on the right,such as catheter failure and catheter tip ectopic during puncture,the neck catheter angle dilated during use,suggesting that the right is preferred for infusion port placement.If you choose to place the infusion port on the left,specific preventive measures need to be strengthened during the operation to avoid human factors to increase complications.