摘要
目的探讨植入式静脉输液港在乳腺癌化疗中的应用,分析其并发症的发生、预防和处理方法。方法回顾性分析合肥医科大学附属医院甲乳外科2016年6月至2019年10月1031例植入式静脉输液港乳腺癌患者的病历资料,并对不同穿刺位置及发生并发症的情况进行分析。结果输液港留置时间5~512 d,平均(177.6±77.6)d。经右侧颈内静脉穿刺置入输液港516例、经左侧颈内静脉穿刺置入460例、经右侧锁骨下静脉穿刺置入34例、经左侧锁骨下静脉穿刺置入21例。经右侧颈内静脉手术完成时间明显短于经左侧颈内静脉手术(P=0.0002)。总体血栓发生率为11.3%,经左侧颈内静脉穿刺血栓发生率显著高于经右侧颈内静脉(14.3%vs 8.3%,P=0.029)。其它并发症包括:输液不畅77例,导管异位12例,局部感染7例,港座处皮肤破溃6例,导管脱落2例(1例采用介入手术取出,1例重新切开连接后正常使用)。结论植入式静脉输液港是乳腺癌化疗患者可选择的长期静脉通路,其保证了输液安全,提高了患者的生活质量,是一种快速、简单、准确、安全、有效的化疗方法,值得广泛推广应用。
Objective To explore the application implantable venous access port in breast cancer patients undergoing chemotherapy,and to analyze the occurrence,prevention and treatment of complications.Methods A retrospective analysis was made on the medical records of 1,031 patients with breast cancer who were received implantable venous access port from June 2016 to October 2019 in the Department of Thyroid and Breast Surgery,Affiliated Hospital of Zunyi Medical University,and the different puncture locations and complications were analyzed.Results The indwelling time at the infusion port was 5~512 d,with an average of(177.6±77.6)d.The port of infusion was implanted via the right internal jugular vein in 516 cases,the left internal jugular vein in 460 cases,the right subclavian vein in 34 cases,and the left subclavian vein in 21 cases.The completion time of right internal jugular vein surgery was significantly shorter than that of left internal jugular vein surgery(P=0.0002).The overall incidence of thrombosis was 11.3%,and puncture catheterization through the left internal jugular vein was significantly higher than that through the right internal jugular vein(14.3%vs 8.3%,P=0.029).Other complications included 77 cases of infusion obstruction,12 cases of catheter ectopic,7 cases of infection,and 6 cases of skin rupture at port.The catheter was detached in 2 cases,of which 1 case was removed by interventional surgery and 1 case was normally used after reconnection.Conclusion Implantable venous access port is a long-term venous access for breast cancer patients undergoing chemotherapy,which ensures the safety of infusion and improves the quality of life of patients.It is a fast,simple,accurate,safe and effective chemotherapy method,which is worthy of widespread application.
作者
李涛浪
马志远
罗迤
吕俊远
侯泽宇
张淇
卢成丽
穆仁敏
汪虎
程晓明
刘雪梅
Li Taolang;Ma Zhiyuan;Luo Yi;Lyu Junyuan;Hou Zeyu;Zhang Qi;Lu Chengli;Mu Renmin;Wang Hu;Cheng Xiaoming;Liu Xuemei(Department of Thyroid and Breast Surgery,Affiliated Hospital of Zunyi Medical University,Zunyi Guizhou 563099,China;Department of Gastroenterology,Affiliated Hospital of Zunyi Medical University,Zunyi Guizhou 563099,China)
出处
《合肥医科大学学报》
2020年第3期347-352,共6页
Journal of Zunyi Medical University
基金
国家自然科学基金资助项目(NO:81660098,81860103)。
关键词
植入式静脉输液港
乳腺癌化疗
导管相关性感染
导管相关性血栓
implantable venous access port
breast cancer chemotherapy
catheter-related infection
catheter-related thrombus
