经颈内静脉与经锁骨下静脉输液港植入的对比研究

Comparison of subcutaneous central venous port via jugular and subclavian access:a retrospective study

目的比较经颈内静脉与经锁骨下静脉输液港植入在肿瘤患者中应用的安全性和有效性。方法选取2017年1月至2019年12月在中国医学科学院肿瘤医院行静脉输液港植入术的肿瘤化疗患者作为研究对象,按静脉入路不同,分为颈内静脉组和锁骨下静脉组,比较2组患者术中和术后相关并发症发生率。结果本研究共纳入患者730例,其中颈内静脉组171例,锁骨下静脉组559例。经颈内静脉组导管机械性并发症(包括导管断裂、导管夹闭和导管脱落)发生率为0.58%(1/171)明显低于经锁骨下静脉组4.65%(26/559),差异有统计学意义(P<0.05)。2组患者血栓形成、感染、导管移位、港座翻转、气胸和血胸发生率比较,差异无统计学意义(P>0.05)。结论由于解剖学上的优势,与经锁骨下静脉入路相比,经颈内静脉输液港植入发生导管机械并发症的概率更低,是需长期化疗的肿瘤患者植入输液港首选路径。

Objective To compare the safety and efficacy of totally implantable venous access ports via jugular and subclavian venous access in cancer patients.Methods Between January 2017 to December 2019,a total of 730 cancer patients received totally implantable venous access ports via jugular or subclavian venous access in our hospital were selected as the research subjects.They were divided into the internal jugular vein group and the subclavian vein group according to access.Complications were compared and analyzed between the two groups.Results This study included a total of 730 patients,including 171 in the internal jugular vein group and 559 in the subclavian vein group.The incidence of catheter-related mechanical complications(including catheter rupture,catheter clamping,and catheter detachment)in the transjugular group was 0.58%(1/171),significantly lower than 4.65%(26/559)in the subclavian vein group,with a statistically significant difference(P<0.05).There was no statistically significant difference in the incidence of thrombosis,infection,catheter displacement,port reversal,pneumothorax,and hemothorax between the two groups(P>0.05).Conclusion Compared with the subclavian vein group,the internal jugular vein group had a lower incidence of catheter-related mechanical complications.Compared with subclavian vein,jugular vein access seems to bea better choice for totally implantable venous access ports implantation in cancer patients.