X线引导下放置植入式输液港在乳腺癌化疗中的应用  

Radiological-guided Insertion of CVAPD in Chemotherapy for Breast Cancer

作　　者：程琳[1] 赵凤琴[1] 杨德启[1] 佟富中[1] 曹迎明[1] 刘宏军[1] 张嘉庆[1] 

机构地区：[1]北京大学人民医院乳腺中心,北京100044

出　　处：《中国微创外科杂志》2011年第7期590-592,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨乳腺癌化疗采用完全植入式输液港作为静脉输液通路的可行性。方法2006年2月一2009年12月，共65例需行化疗的乳腺癌患者在术中X线引导下行输液港装置植入术。局部麻醉下行锁骨下静脉或颈内静脉穿刺术，术中X线引导确认导管向上腔静脉方向走行及导管尖端位置位于上腔静脉根部水平。观察围手术期和输液港植人术后的长期并发症。结果全部病例均在术中X线引导下完成输液港植入。发生气胸3例，1例需要行胸腔闭式引流。2例切口愈合不良，其中1例取出输液港后愈合，1例将输液港移位后愈合。中位随访22个月（4～35个月），应用输液港装置化疗中输液顺畅，无渗漏，未发生导管相关性感染、导管阻塞和夹闭综合征。结论X线引导下输液港植入是乳腺癌化疗有效和安全的输液途径。主要并发症包括穿刺相关并发症如气胸，远期并发症如导管阻塞、导管相关性感染。Objective To assess the feasibility of using implanted central venous access port devices （CVAPD） for chemotherapy in patients with breast cancer. Methods From February 2006 to December 2009, under radiological guidance, we used CVAPD for chemotherapy in 65 cases of breast cancer. Under local anesthesia and guidance by X-ray, with subclavian vein or internal jugular vein puncture, we inserted CVAPD with the tip point of the catheter reached the proximal end of the superior vena cava. Perioperational and long-term complications of the procedure were observed closely. Results CVAPD was inserted under the guidance of X-ray in all the cases. Among the patients, pneumothorax occurred in three of the cases, one of them had to receive closed chest drainage; two patients had the incision unhealed： one of them was cured by removing the CVAPD, and the other recovered after transposition of the device. The patients were followed up for a median of 22 months （4 to 35 months） , during which CVAPD worked well without leakage, infection, occlusion or pinch-off syndrome. Conclusions Radiological-guided insertion of CVAPD is effective and safe for patients receiving chemotherapy for breast cancer. The major complication of the procedure is pneumothorax, and long-term complications include occlusion of the catheter and catheter-related infection.

关 键 词：完全植入式静脉输液港 乳腺癌 化疗 

分 类 号：R472[医药卫生—护理学]