左侧锁骨下动脉入路植入导管药盒系统行HAIC治疗的技术初探

Preliminary study on the technique of HAIC treatment with left subclavian artery implantation port-catheter system

目的探讨经皮左锁骨下动脉途径植入导管药盒系统(port-catheter system,PCS)技术的优势和特点。方法选取我院不可切除的原发性肝脏恶性肿瘤41例患者的临床资料,通过经皮植入导管药盒系统行肝动脉灌注化疗(hepatic arterial infusion chemotherapy,HAIC)治疗,记录并发症情况(出血、感染、导管头移位、脱管、闭塞)和患者生活状态。结果技术成功率100%,4例(9.7%)出现与置管相关(出血、感染)的并发症,其中2例为穿刺点周围血肿,1例为囊袋内血肿,1例为切口愈合不良;3例(7.3%)患者发生导管移位或脱管,2例患者取出药盒系统。所有患者生活基本不受影响。本组随访期间客观缓解率ORR为48.4%。结论经左侧锁骨下动脉途径植入导管药盒系统行HAIC治疗安全可行,对患者生活影响较小,接受度高。

Objective To explore the advantages and characteristics of the port-catheter system(PCS)technique through percutaneous left subclavian artery approach.Methods The clinical data of 41 patients with unresectable primary liver malignancies in our hospital were collected.The patients were treated with hepatic arterial infusion chemotherapy(HAIC)by port-catheter system.The complications(bleeding,infection,catheter displacement,removal,occlusion)and life status of patients were recorded.Results The technical success rate was 100%.Complications related to catheter placement(bleeding,infection)occurred in 4 cases(9.7%),including 2 cases of hematoma around the puncture site,1 case of hematoma in the capsular bag,and 1 case of poor incision healing;3 patients(7.3%)had catheter displacement or detachment,and finally,2 patients were removed from the cartridge system.The lives of all patients were basically unaffected.Conclusion It is safe and feasible to implant the port-catheter system,through the left subclavian artery for HAIC treatment,which has little impact on the life of patients and is highly acceptable.