经颈内静脉植入输液港:导管尖端处于不同位置时1年内并发症发生率与导管通畅率

Incidence of complications and catheter patency rate between different locations of catheter tip of venous access ports implanted through internal jugular vein within 1 year

目的对比观察经颈内静脉(IJV)入路植入完全植入式静脉输液港(TIVAP)后,导管尖端处于不同位置时1年内并发症发生率及导管通畅率。方法回顾性分析2104例接受经IJV入路植入TIVAP的肿瘤患者,将接受经右IJV入路者(R组,n=1903)分为导管尖端位于右心房上部[即上腔静脉(SVC)与右心房交界(CAJ)下方0.5~1.0 cm亚组(R1亚组,n=376)]与位于SVC下1/3至CAJ间亚组(R2亚组,n=1527),将接受经左IJV入路者(L组,n=201)相应分为L1亚组(n=64)及L2亚组(n=137);记录2组内各亚组患者基本资料、植入TIVAP 1年内并发症发生率及导管通畅率,并进行亚组间比较。结果2组内亚组间患者性别、年龄、临床诊断及肿瘤分期,以及气胸/血气胸、局部皮肤损伤、TIVAP感染、导管相关性血栓、药物外渗、导管移位及心律失常等并发症发生率差异均无统计学意义(P均>0.05)。R1(94.15%)与R2亚组(93.78%)(χ2=0.069,P=0.793)、L1(98.44%)与L2亚组(89.78%)1年内导管通畅率差异均无统计学意义(Yates连续性校正χ2=3.563,P=0.059)。结论经左或右IJV入路植入TIVAP后,导管尖端位于右心房上部与SVC下1/3与CAJ之间时,1年内并发症发生率及导管通畅率均无明显差异。

Objective To comparatively observe the incidence of complications and patency rate within 1 year after implantation of totally implantable venous access port(TIVAP)through internal jugular vein(IJV)between different locations of catheter tip.Methods Data of 2104 patients with tumors who received TIVAP implantation through IJV were retrospectively analyzed.Patients who underwent TIVAP implantation through the right IJV(group R,n=1903)were divided into R1(n=376,with catheter tip located at the upper right atrium,i.e.0.5 to 1.0 cm below the cavoatrial junction[CAJ])and R2 subgroups(n=1527,with catheter tips located between the lower 1/3 of superior vena cava[SVC]and CAJ),while those who underwent TIVAP implantation through the left IJV(group L,n=201)were divided into L1(n=64)and L2 subgroups(n=137),respectively.Patients’basic information,incidence of complication and patency rate of catheter 1 year after TIVAP implantation were collected and compared between subgroups.Results No significant difference of gender,age,clinical diagnosis,tumor stage,nor of incidence of complication including pneumothorax/hemopneumothorax,local skin injury,TIVAP infection,catheter-associated thrombosis,drug extravasation,catheter displacement and arrhythmia was found between subgroups within group R nor L(all P>0.05).One year after TIVAP implantation,no significant difference of catheter patency rates was found between subgroup R1(94.15%)and R2(93.78%)(χ2=0.069,P=0.793),nor between subgroup L1(98.44%)and L2(89.78%)(Yates’continuity correctionχ2=3.563,P=0.059).Conclusion No significant difference of incidence of complications nor catheter patency rate within 1 year after implantation of TIVAP was found between catheter tip location at the upper right atrium or between the lower 1/3 of SVC and CAJ through the right or left IJC.