目的：探讨经颈外静脉放置全植入式输液港（ totally implantable venous access ports，TIVAP）作为肿瘤化疗静脉输液通路的可行性及术后并发症。方法对2010年1月～2013年12月96例行输液港植入术的肿瘤化疗患者进行回顾性研究，观察围手术期和远期并发症。结果全部病例均在术中完成输液港植入。经颈外静脉置管成功率95．8％（92／96）；2例因术前曾行放疗静脉挛缩，2例血管过细无法植入导管，改行同侧颈内静脉穿刺置管。术后中位随访26个月（8～46个月），并发症发生率6．2％（6／96）。其中2例因肿瘤复发压迫造成输液港导管闭塞，1例导管移位，2例血栓形成，l例锁骨区皮肤疼痛。应用输液港装置化疗中输液顺畅，无渗漏，未发生气胸、血胸、导管相关性感染和夹闭综合征。结论经颈外静脉切开放置全植入式输液港是肿瘤化疗安全、快捷和有效的输液途径，可以避免气胸、血胸、夹闭综合征等严重并发症，主要并发症包括导管移位、阻塞、血栓形成。%Objective To explore the feasibility and complications of totally implantable venous access ports ( TIVAP ) implanted via external jugular vein in chemotherapy for cancers. Methods A retrospective review was conducted on 96 patients undergoing a TIVAP implantation for chemotherapy at this hospital from January 2010 to December 2013.Perioperational and long-term complications of the procedure were observed. Results The TIVAP was inserted in all the cases.The external jugular vein approach was successfully utilized in 92 cases (95.8%).In the remaining 4 cases (4.2%), the TIVAP placement was performed through ipsilateral internal jugular vein because of contractured vein due to preoperatively radiotherapy in the neck area in 2 cases and fine veins unable to implant the catheter in 2 cases.No immediate postoperative complications were detected.The patients were followed up for a median of 26 months (8-46 months).The overall complication rate was 6.2% (6/96).There were 2 cases of catheter occlusion because of tumor recurrence, 1 case of migration of the catheter, 2 cases of thrombogenesis, and 1 case of clavicular skin pain.TIVAP worked well without leakage, pneumothorax, infection, or pinch-off syndrome. Conclusions External jugular vein approach appears to be a highly successful and safe alternative route and may be considered a potentially useful primary route for TIVAP placement in cancer patients.Main complications include catheter migration, occlusion, and thrombosis.
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