完全植入式静脉输液港与经外周静脉穿刺中心静脉置管在乳腺癌患者化疗中的应用效果比较  

Comparison of totally implantable venous-access port and peripherally inserted central catheter in chemotherapy of breast cancer patients

作　　者：毕铁强[1] 周军[1] 汪瑞[1] 刘海[1] 

机构地区：[1]江苏省连云港市第一人民医院甲状腺乳腺外科,222002

出　　处：《中华乳腺病杂志（电子版）》2014年第2期25-28,共4页Chinese Journal of Breast Disease(Electronic Edition)

摘　　要：目的比较完全植入式静脉输液港(TIVAP)和经外周静脉穿刺中心静脉置管(PICC)在乳腺癌患者静脉化疗中的应用效果。方法选取2011年5月至2013年4月在本科住院的297例乳腺癌术后化疗患者,按照中心静脉置管方式分为PICC组(n=187)和TIVAP组(n=110)。将两组置管成功率、并发症发生率及患者带管期间生活质量进行比较。统计学方法采用t检验和χ2检验。结果 TIVAP组一次性置管成功率略低于PICC组[84.55%(93/110)比92.51%(173/187),χ2=4.70,P=0.03];TIVAP组并发症的发生率低于PICC组[1.82%(2/110)比9.09%(17/187),χ2=6.12,P=0.01];与TIVAP组比较,PICC组患者带管期间生活质量明显下降[PICC组与TIVAP组生活质量较好的比例分别为90.91%(170/187)比100%(110/110),χ2=10.61,P=0.00]。结论 TIVAP虽然操作较PICC复杂,价格高于PICC,但其具有留置时间长、并发症少、导管维护间隔时间长、对患者生活质量影响小等优点,值得在静脉化疗的乳腺癌患者中推广应用。Objective To compare peripherally inserted central catheter （ PICC） and totally implantable venous-access port （ TIVAP） in breast cancer patients with intravenous chemotherapy. Methods Totally 297 breast cancer patients who underwent postoperative chemotherapy after breast cancer surgery in our department from May 2011 to April 2013 were divided into PICC group （n=187） and TIVAP group （n=110）. Successful catheterization rate, complication rate and quality of life during intravenous chemotherapy were compared. All data were analyzed using t test and Chi-square test. Results The successful one-time catheterization rate in TIVAP group was slightly lower than that in PICC group [84. 55%（93/110）vs 92. 51%（173/187）,χ^2=4. 70, P=0. 03];complication rate in TIVAP group was lower than that in PICC group [1. 82%（2/110） vs 9. 09%（17/187）,χ^2=6. 12,P=0. 01]; compared with TIVAP group, the quality of life of patients in PICC group declined significantly [ the proportion of the patients with good life quality in PICC group vs that in TIVAP group：90%（170/187）vs 100%（110/110）,χ^2=10. 61, P=0. 00]. Conclusion In spite of higher cost and more complicated operation, TIVAP has some advantages over PICC, such as longer retention time, fewer complications, longer catheter maintenance intervals and less impact on life quality of patients, which is feasible for intravenous chemotherapy in breast cancer patients.

关 键 词：导管插入术 中心静脉 输注泵 植入型 乳腺肿瘤 化学疗法 

分 类 号：R737.9[医药卫生—肿瘤]