完全植入式静脉输液港在HIV/AIDS患者中的应用效果

Application effect of totally implantable venous access port in HIV/AIDS patients

目的探讨完全植入式静脉输液港(TIVAP)在人类免疫缺陷病毒/获得性免疫缺陷综合征(HIV/AIDS)患者中的应用效果。方法回顾性分析2019年6月至2022年9月苏州大学附属传染病医院在数字剪影血管造影机X线透视引导下经胸壁放置TIVAP的10例HIV/AIDS患者的临床资料及随访结果,观察围手术期并发症、术后导管通畅性等情况。结果10例HIV/AIDS患者均成功置入TIVAP,手术成功率100%。术后有2例TIVAP发生局部感染,并取出,余8例TIVAP正常使用。随访期内未见感染,无气胸、血肿、导管夹闭综合征、TIVAP导管处静脉血栓及导管锁脱落等并发症发生。结论HIV/AIDS患者放置TIVAP具有成功率高、方便、微创等特点,值得临床进一步推广应用,但术后感染率较普通人群高,应加强围手术期管理,积极处理术后感染,以显著改善患者预后。

Objective To explore the application effect of totally implantable venous access port(TIVAP)in patients with human immunodeficiency virus/acquired immunodeficiency syndrome(HIV/AIDS).Methods The clinical data and follow-up results of 10 HIV/AIDS patients who were placed with TIVAP through the chest wall under the guidance of X-ray fluoroscopy of digital silhouette angiography in the Affiliated Infectious Disease Hospital of Soochow University from June 2019 to September 2022 were retrospectively analyzed.The perioperative complications and postoperative catheter patency were observed.Results TIVAP was successfully implanted in 10 HIV/AIDS patients,and the success rate of operation was 100%.Local infection occurred in 2 cases of TIVAP after operation,and TIVAP was removed;the remaining 8 cases of TIVAP were used normally.No infection,pneumothorax,hematoma,catheter clamping syndrome,venous thrombosis at the TIVAP catheter and catheter lock shedding occurred during the follow-up period.Conclusion The placement of TIVAP in HIV/AIDS patients has the characteristics of high success rate,convenience and minimally invasive,which is worthy of further clinical application.However,the postoperative infection rate is higher than that of the general population.Perioperative management should be strengthened and postoperative infection should be actively treated so as to can significantly improve the prognosis of patients.