全植入式静脉港在乳腺癌患者化疗中的应用效果分析

Application of Totally implantable Venous Access Port in Breast Cancer Patients

目的 分析全植入式静脉港(TIVAP)在乳腺癌患者化疗中的应用效果。方法 回顾性分析2017-01—2019-10在郑州大学第一附属医院乳腺外科经颈内静脉置入胸壁TIVAP的960例乳腺癌患者的临床资料,观察并发症与穿刺位置的关系、并发症类型及诱因。结果 经右侧颈内静脉穿刺置入TIVAP 570例,经左侧颈内静脉穿刺置入390例。共有68例(7.1%)患者发生并发症,其中右侧发生并发症25例(4.4%)、左侧发生并发症43例(11.0%),差异有统计学意义(P<0.05)。右侧导管相关血栓8例,左侧17例,差异有统计学意义(P<0.05)。右侧导管尖端异位2例,左侧16例,差异有统计学意义(P<0.05)。其他并发症包括感染11例、港座外露5例、港座翻转3例,以及导管阻塞6例。结论 行TIVAP植入化疗的乳腺癌患者,右侧颈内静脉穿刺置入的并发症总发生率、导管相关血栓及尖端异位的发生率均明显低于左侧,因此应尽量选择右侧颈内静脉穿刺置入TIVAP。

Objective To analyze the effect of total implantable intravenous port(TIVAP)in chemotherapy for breast cancer patients.Methods To retrospectively analyze the clinical data of 960 breast cancer patients with TIVAP placed in the chest wall via internal jugular vein in the Department of Breast Surgery.The relationship between complication and puncture location,types of complication and causative factors were observed.Results The infusion port was placed via right internal jugular vein puncture in 570 cases and via left internal jugular vein puncture in 390 cases.Complications occurred in a total of 68(7.1%)patients.Among them,25(4.4%)complications occurred on the right side and 43(11.0%)on the left side,with statistically significant differences(P<0.05).There were 8 cases of catheter-related thrombosis on the right side and 17 cases on the left side,with a statistically significant difference(P<0.05).There were 2 cases of catheter tip ectasia on the right side and 16 cases on the left side,with a statistically significant difference(P<0.05).Other complications included infection in 11 cases,port seat exposure in 5 cases,port seat overturning in 3 cases,and catheter obstruction in 6 cases.Conclusion In breast cancer patients treated with TIVAP implantation,the complication rate,catheter-related thrombosis,and tip ectasia are significantly lower for right-sided internal jugular vein puncture placement than for left-sided patients.Therefore,right-sided internal jugular vein puncture for TIVAP placement should be chosen as much as possible.