上臂型完全植入式给药装置在肿瘤患者中的临床应用

Clinical application of upper arm central venous port in cancer patients

目的探讨上臂型完全植入式给药装置在肿瘤患者中的临床应用效果。方法选择中山大学附属第三医院肿瘤内科2018年3月29日至2020年1月19日共500例肿瘤患者为研究对象,予植入上臂型输液港,记录患者置管信息及随访患者在留置期间发生的导管相关性血栓、导管相关性血流感染等并发症。结果1例合并有重度上腔静脉综合征的患者置管失败,余499例均置入成功,置入成功率为99.8%(499/500)。并发症的发生率为2.6%(13/499),导管相关性血流感染的发生率为0.029‰(4/139614),发生导管相关性血栓的发生率为0.057‰(8/139614),港体翻转、正中神经损伤、局部组织坏死、淋巴漏各1例。15例患者计划内拔管,6例因并发症非计划性拔管。结论上臂型完全植入式给药装置并发症较少,适用于肿瘤化疗及长期需要输液的患者,值得临床推广。

Objective To investigate the clinical effect of upper arm central venous port in cancer patients.Methods A total of 500 patients with tumor were selected as the study subjects from March 29,2018 to January 192020.Complications such as catheter-related thrombosis and catheter-related bloodstream infection during the indwelling period were recorded.Results One patient with severe superior vena cava syndrome failed to be intubated.The other 499 patients were successfully intubated with a success rate of 99.8%(499/500).The rate of complications was 2.6%(13/499),and the rate of catheter-related bloodstream infection was 0.029‰(4/139614)in 4 cases,the incidence of catheter-related thrombus was 0.057‰(8/139614)in 8 cases.There were 1 case of body turnover,1 case of median nerve injury,1 case of local tissue necrosis and 1 case of lymphatic leakage.Extubation was planned in 15 patients,and unplanned extubation in 6 patients due to complications.Conclusions The upper arm port has less complications and is suitable for patients with tumor chemotherapy and long-term need of infusion.It is worthy of clinical promotion.