563例患者植入式输液港维护间隔时间及并发症的回顾性调查研究

A retrospective observational study on maintenance and complications of totally implantable venous access ports in 563 patients:Prolonged versus short flushing intervals

目的评估带有植入式输液港的患者在非治疗期间延长输液港维护间隔时间是否会增加输液港相关并发症的发生.方法对在医院PICC门诊进行输液港维护的治疗间歇期肿瘤患者进行回顾性调查分析.收集患者及输液港的相关信息,对输液港维护间隔时间不同患者的并发症发生情况进行比较和分析.计量资料采用方差分析或非参数检验进行分析,输液港相关性并发症发生率采用卡方检验或Fisher's精确检验进行分析.结果研究共回顾了607例患者的资料,最终563例患者被纳入研究.共观察到13例输液港并发症,包括11例导管堵塞(1.95%)、1例输液港翻转(0.18%)及1例导管异位(0.18%),无导管相关性血流感染及血栓等并发症.患者的平均维护间隔时间为35.27 d(SD=13.09).根据维护间隔时间,患者分为3组,≤28 d组133例,29~44 d组350例,≥45 d组80例.3组输液港相关并发症发生率差异无统计学意义(P=0.28).结论带有植入式输液港的患者在治疗间歇期若连续1年无输液港相关并发症发生史,可尝试将输液港的维护间隔时间延长至4周以上,5~6周或许是个合适的选择.

Objectives:To assess whether the extension of the flushing interval will increase risks of complications associated with totally implantable venous access port(TIVAP)in the off-treatment period.Methods:A retrospective single-center observational study was performed.Patients with a TIVAP in the off-treatment period that underwent regular flushing in our clinic were included.Data concerning patients and their TIVAPs were recorded.Patient baseline characteristics and TIVAP-related complications were analyzed.Continuous variables were analyzed by ANOVA or the Kruskal-Wallis H test.To compare the occurrence of TIVAP-related complications,the chi-square test was used;if needed,Fisher’s exact test was used.Results:Totally 607 patients were reviewed,and 563 patients were finally included.Thirteen complications were recorded,including 11 cases of catheter occlusion(1.95%),one case of port cannula rotation(0.18%),and one case of catheter tip malposition(0.18%).No device-related infection or venous thrombosis was recorded.Among these patients,the average flushing interval was 35.27±13.09 days.Patients were divided into three groups according to the flushing interval:every 28 days or less(Group 1,n=133);every 29-44 days(Group 2,n=350);and every 45 days or more(Group 3,n=80).No significant difference in catheter-related complications was found among the three groups(P>0.05).Conclusions:In the TIVAP off-treatment period,patients without any history of TIVAP-related complications during approximately one year can attempt to prolong the flushing interval to more than 4 weeks;we further suggest that 5-6 weeks may be an appropriate option for these patients.