植入式静脉输液港相关并发症的临床分析

摘要

Objective To explore the incidence and clinical treatment of related complications caused by implantable venous access port(IVAP) in patients with breast cancer during chemotherapy.Methods The data of 755 patients with breast cancer recieved chemotherapy by which caused some related complications in our hospital from January 2014 to March 2016 were retrospectively analyzed.Results 753 patients IVAPs were implanted succussfully.The total placement time of implantable venous access port was from 110 days to 940 days,with median placement 147.33 days.The related complications of IVAP were catheter malposition(0.79％,6/755),catheter-related thrombosis(27.81％,210/755),catheter fracture(0.13％,1/755),port exposure(0.93％,7/755) and IVAP-related bloodstream infection(0.13％,1/755).The IVAP-related complications and thrombosis rate were significant higher when IVAPs implanted in the left internal jugular veincompared with that in right internal jugular vein(34.88％ vs.25.74％,33.10％ vs.24.68％).Conclusion Application of IVAP in patients with breast cancer during chemotherapy is a safe and effective operation.The most common complication is asymptomatic mural thrombus formation around the catheter,which should be paid attention to.%目的 探讨乳腺癌患者使用植入式静脉输液港相关并发症及其临床处理方法.方法 回顾性分析我院2014年1月至2016年3月755例乳腺癌患者使用植入式静脉输液港化疗后并发症及其临床处理方法.结果 753例置港成功并已顺利取港,输液港总置管时间为110～940 d,平均置管时间为147.33 d.输液港并发症为导管异位、导管相关性血栓形成、导管脱落、港体外露及输液港相关性血流感染,发生率分别为0.79％(6/755)、27.81％(210/755)、0.13％(1/755)、0.93％(7/755)和0.13％(1/755).其中经左侧颈内静脉穿刺置港的并发症发生率34.88％,右侧为25.74％,左右对比差异有统计学意义(P=0.008).左侧输液港置入血栓发生率为33.10％,右侧为24.68％,左右侧对比差异有统计学意义(P=0.013).结论 乳腺癌患者化疗期间使用植入式静脉输液港化疗安全有效,经右侧颈内静脉置入输液港并发症发生率低;输液港最常见的并发症为输液港导管周围无症状附壁血栓形成,应予以重视.