经皮左锁骨下动脉导管药盒系统植入术的并发症及其处理  

Percutaneous port catheter system implantation via left subclavian artery: related complications and management

作　　者：陈勇 李彦豪[1,2,3] 单鸿[1,2,3] 罗鹏飞[1,2,3] 何晓峰 陈卫国[1,2,3] 

机构地区：[1]第一军医大学附属南方医院放射科 [2]中山医科大学附属第三医院放射科 [3]广东省人民医院肿瘤科

出　　处：《中华放射学杂志》1997年第8期540-542,共3页Chinese Journal of Radiology

摘　　要：目的：探讨经皮左锁骨下动脉行导管药盒系统（ＰＣＳ）植入术的安全性。材料与方法：对１１５例胸、腹部及盆腔恶性实质性肿瘤患者（其中肝癌１０１例），经皮左锁骨下动脉穿刺行ＰＣＳ植入术。术后经ＰＣＳ行规律性化疗或碘油化疗乳剂栓塞。统计与该术有关的并发症。结果：并发症有气胸５例（４．３％），血胸１例（０．９％），植入药盒部位感染３例（２．６％），切口延迟愈合或开裂５例（４．３％），留置管移位６例（５．２％）。所有并发症经处理均痊愈，无严重后遗症及死亡病例。其中大量气、血胸３例，采用８Ｆ胸腔穿刺系统行胸腔闭式引流治疗痊愈；留置管移位者４例进行ＰＣＳ重植入术成功，３例拔除ＰＣＳ，均未见并发症。结论：经皮左锁骨下动脉行ＰＣＳ植入术的并发症少而轻，经适当处理多可痊愈，为动脉内化疗灌注和碘油化疗乳剂栓塞提供了一种安全可靠的途径。Purpose: To evaluate the security of percutaneous port catheter system (PCS) implantation via left subclavicular artery in the treatment of malignant solid tumors. Materials and methods:The technique was used to treat thoracic, abdominal and pelvic malignant tumors in 115 patients.Intra arterial chemotherapy or chemoembolization with emulsion of anticancerous agents and lipiodol were regularly carried out via PCS. The complications related to the technique were observed. Results: Complications occurred in 20 cases (17.4%), including pneumothorax (5 cases, 4.3%), hemothorax (1 case, 0.9%), wound delayed healing or wound dehiscence (5 case, 4.3%) infection (3 cases, 2.6%), and indwelling catheter tip dislocation (6 cases, 5.2%). Most of these cases were recovered after appropriate management, without fatality and severe sequalae. Massive pneumothorax ( n =3) and hemothorax( n =1) were managed by thoracocentesis or closed drainage.Migrating catheter tips were reinserted into the target artery in 4 cases. PCS were pull out in 3 cases. Conclusion: It is believed that percutaneous PCS implantation via left subclavicular artery provides a safe intra arterial chemotherapy or chemoembolization access for patients with malignant solid tumor.

关 键 词：锁骨下动脉 手术并发症 肿瘤 药盒系统植入 

分 类 号：R730.53[医药卫生—肿瘤]