乳腺癌患者携带颈内静脉插管的可行性  

Feasibility mobile internal jugular vein cannulation for breast cancer patients

作　　者：陈显春[1] 伍素华[1] 杨英[1] 宋爽[1] 王泽惠[1] 王寅欢[1] 

机构地区：[1]第三军医大学西南医院乳腺疾病中心,重庆400038

出　　处：《中华乳腺病杂志（电子版）》2009年第6期19-21,共3页Chinese Journal of Breast Disease(Electronic Edition)

摘　　要：目的探讨乳腺癌患者院外携带颈内静脉插管的可行性。方法2007年10月至2008年1月收集122例资料完整且携带颈内静脉插管的乳腺癌患者,并对其插管局部情况、体温、血常规、拔除颈内静脉插管时进行导管尖端、导管血细菌培养和鉴定的资料进行分析。结果携带颈内静脉插管的122例乳腺癌患者,导管携带时间最短5d,最长122d,平均46d;导管留置期间患者体温正常,血白细胞计数正常,无发冷、发热主观症状;5例患者拔管时插管处有红肿、疼痛、局部硬结0.2～0.5cm;19例患者导管尖端细菌培养为阳性,阳性率15.60%(19/122),12例患者导管血细菌培养阳性,阳性率9.80%(12/122);病原菌主要为表皮葡萄球菌、少动假单胞菌、真菌(酵母菌)、奇异变形杆菌、人葡萄球菌人亚种等。结论乳腺癌患者院外携带颈内静脉插管,虽有一定的感染危险性,经随访3个月,患者情况良好,未造成不良后果,因此,乳腺癌患者院外携带颈内静脉插管是可行的,但对乳腺癌患者颈内静脉插管引起的相关感染问题仍不可忽略,应引起高度重视,防止不良后果发生。Objective To explore the feasibility and safety of mobile internal jugular vein eannulation for breast cancer patients. Methods From October 2007 to January 2008, 122 breast cancer patients with complete data of using mobile internal jugular vein cannulation were collected . Their local status of cannulation, temperature, blood routine, and the results of the catheter tip bacteria and blood bacteria that were immediately cultured and assessed after removal of the catheter were analyzed. Results The time from cannulation to removal of the catheter in the 122 breast cancer patients was 5-122 days （mean 46 days）. During the catheter indwelling the temperature and lencocyte count of the patients were normal, and no symptoms of cold and fever occurred. Flare, pain and induration of 0.2-0.5 cm at the cannulation site after removal of the catheter occurred in 5cases. In 19 cases the catheter tip baterial culture was positive, with the positive rate of 15.60% （19/122）, in 12 cases the blood bacteria culture was positive, with the positive rate of 9.80%（12/122）. Pathogenic bacteria were mainly staphylococcus epidermidis, pseudomonad, eumycete （budding fungus）, proteusmirabilis, human staphylococci, etc. Conclusion Although there are infection risks in mobile internal jugular vein cannualtion for breast cancer patients, the 3 month follow up of our patients showed the patients＇ status was good after treatment, and no bad consequences occurred. So mobile internal jugular vein cannuahion for breast cancer patients is feasible, but cannulation-related infection should be given much attention in order to avoid bad events.

关 键 词：乳腺肿瘤 颈内静脉插管 安全性 细菌培养 

分 类 号：R737.9[医药卫生—肿瘤]