不同路径植入静脉输液港并发症的临床研究

Clinical Application on Complications of Implantable Venous-Access Port through Different Routes

目的:评价股静脉、锁骨下静脉、颈内静脉全植入术治疗恶性肿瘤的安全性及并发症临床应用。方法:选择2016年9月至2020年12月接受植入式静脉输液港的286例患者开展回顾性分析,全植入式静脉通路端口286个,其中股静脉43个、颈内静脉100个、锁骨下静脉143个,分析患者术后3组不同植入路径发生并发症的影响因素。结果:286例全植入术静脉通道中发生并发症77例(26.9%),其中导管阻塞16例,血流感染14例,皮肤破裂7例,中央静脉血栓形成6例,导管移位3例,回抽无回血6例。286个完全可植入式静脉通路中未发现年龄、性别、输液港位置、肿瘤类型、导管类型与并发症有相关性(P 】0.05)。股静脉组术后血栓症发生率高于锁骨下静脉和颈内静脉组(P 0.05)。结论:经股静脉、锁骨下静脉或颈内静脉全植入式静脉通道移植在恶性肿瘤患者中是安全可行的,且通道相关并发症发生率低。

Objective: To evaluate the safety and complications of totally implantable venous access port implantation via femoral vein, subclavian vein or internal jugular vein in patients with malignancy. Method: A total of 286 totally implantable venous access ports were placed in 286 patients with malignancy between Sep 2016 and Dec 2020 (43 via femoral vein, 100 via jugular vein and 143 via subclavian vein). The influencing factors of postoperative complications in 3 groups of patients with different implantation paths were analyzed. Result: Among the 286 cases of total implantation, 77 cases (26.9%) had complications, including catheter obstruction in 16 cases, bloodstream infection in 14 cases, skin rupture in 7 cases, central venous thrombosis in 6 cases, catheter displacement in 3 cases, and no blood return in 6 cases. There was no correlation between age, gender, infusion port location, tumor type, catheter type and complications in 286 fully implantable venous pathways (P >0.05). The incidence of postoperative thrombosis in the femoral vein group was higher than that in the subclavian vein group and the internal jugular vein group (P 0.05). Conclusion: These data indicate that totally implantable venous access port implantation via the femoral vein, subclavian vein or internal jugular vein in patients with malignancy is safe and feasible, with a low access-related complication rate.