经颈静脉及锁骨下静脉输液港植入术并发症的比较分析

Comparative analysis of complications of trans-jugular and subclavian intravenous infusion port implantation

目的探讨经颈静脉、锁骨下静脉输液港植入术并发症的发生率及处理措施。方法选取2016年1月至2018年1月于本科行颈静脉、锁骨下静脉输液港植入术患者156例作为研究对象,分为A组(n=80)与B组(n=76)。A组行颈静脉穿刺途径,B组经锁骨下静脉途径,比较两组并发症发生率、1年导管通畅率。结果A组患者成功实施经颈静脉输液港植入79例,技术成功率98.75%,发生港体相关性并发症5例,发生率6.25%;发生导管相关性并发症6例,发生率7.50%,无导管夹闭综合征发生;发生感染相关性并发症8例,发生率10.00%,随访1年导管通畅率为92.50%。B组患者成功实施经锁骨下静脉输液港植入术73例,技术成功率96.05%,发生港体相关性并发症6例,发生率7.89%;发生导管相关性并发症15例,发生率19.74%,其中发生导管夹闭5例,发生率6.58%;发生感染相关性并发症5例,发生率6.58%,1年通畅率为81.57%。B组导管夹闭综合征发生率高于A组(P<0.05),1年导管通畅率低于A组(P<0.05),两组技术成功率及港体、导管、感染性并发症发生率比较差异无统计学意义。结论经颈静脉输液港植入术无导管夹闭综合征发生,1年导管通畅率高于经锁骨下静脉路径,可作为输液港植入术患者的首选途径。

Objective To investigate the incidence and management of complications of trans-jugular and subclavian intravenou sinfusion port implantation.Methods 156 patients with trans-jugular and subclavian intravenou sinfusion port implantation in our department from January 2016 to January 2018 were divided into group A(n=80)and group B(n=76).Group A was treated with jugular vein puncture approach and group B was treated with subclavian vein approach.The incidence of complications and the 1-yearpatency rate of catheter were compared between two groups.Results In group A,76 cases were successfully treated with trans-jugular intravenou sinfusion port implantation,with the technical success rate of 95.00%.There were 5 cases of port-related complications,with the incidence rate of 6.25%.There were 6 cases of catheter-related complications,with incidence rate of 7.50%and there was no incidence of catheter pinch-off syndrome;there were 8 cases of infection-related complications,with incidence rate of 10.00%and catheter patency rate of 92.50%after 1 year follow-up.In group B,68 cases were successfully treated with trans-subclavian intravenou sinfusion port implantation,with the technical success rate of 89.47%.There were 6 cases of port-related complications,with the incidence rate of 7.89%.There were 15 cases of catheter-related complications,with the incidence rate of 19.74%,including 5 cases of catheter pinch-off syndrome,with an incidence of 6.58%and 1-year patency rate of 81.57%.The incidence of catheter clamping syndrome in group B was higher than group A(P<0.05),and the 1-year catheter patency rate was lower than group A(P<0.05).There was no statistical difference in the technical success rate and concurrent incidence of port body,catheter,and infection between two groups.Conclusion There was no incidence of catheter pinchoff syndrome in trans-jugular intravenou sinfusion port implantation,and the patency rate of catheter in 1-year is higher than the subclavian vein approach,which could be used as the preferred approach for patients with infusion port implantation.