外周静脉置入中心静脉导管与植入式静脉输液港在乳腺癌化疗中的应用  

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

作　　者：郑明康[1] 陈辉[2] 

机构地区：[1]广东省珠海市妇幼保健院普外科,广东珠海519000 [2]华中科技大学同济医学院儿少卫生与妇幼保健学系,湖北武汉430030

出　　处：《中国医药导报》2014年第29期47-50,54,共5页China Medical Herald

摘　　要：目的 通过对外周静脉置入中心静脉导管（PICC）与植入式静脉输液港（TIVAP）在乳腺癌化疗的应用比较,为乳腺癌化疗选择理想深静脉通道提供科学依据。方法 收集2008年7月～2012年1月于珠海市妇幼保健院诊治的乳腺癌患者244例,按照置管方式分为PICC组（139例）及TIVAP组（105例）。对两组患者在置管操作时间、置管长度、置管成功率、置管并发症发生率等各方面进行对比分析。结果 PICC组置管操作时间[（12.63±8.03）min]明显少于TIVAP组[（33.84±11.74）min],PICC组置管长度[（42.85±2.48）cm]长于TIVAP组[（11.76±0.70）cm],差异均有高度统计学意义（P〈0.01）。两组置管总成功率均为100.00%,PICC组一次置管成功率为92.09%（128/139）,二次置管成功率为6.47%（9/139）,三次置管成功率为1.44%（2/139）;TIVAP组一次置管成功率为88.57%（93/105）,二次置管成功率为11.43%（12/105）;两组置管成功率及一次置管成功率比较,差异均无统计学意义（P〉0.05）。PICC组的导管异位发生率（9.35%）、静脉炎发生率（9.35%）及导管堵塞发生率（4.32%）均高于TIVAP组（均为0.00%）,差异均有统计学意义（P〈0.05）;TIVAP组总并发症发生率（9.52%）低于PICC组总并发症发生率（35.97%）,差异有高度统计学意义（P〈0.01）。结论 TIVAP比PICC并发症发生率低,更加安全、可靠,可作为乳腺癌化疗理想深静脉通道。Objective To compare peripherally inserted central catheter （PICC） and totally implantable venous access port （TIVAP） in chemotherapy of breast cancer, and provide scientific basis for choosing ideal deep venous channel. Methods From July 2008 to January 2012, in Maternity and Child Health Hospital of Zhuhai City, 244 patients with breast cancer were enrolled and divided into two groups： PICC group （139 cases） and TIVAP group （105 cases）. Operat- ing time, catheter length, success rate and incidence rate of complication were compared between the two groups. Re- sults The average operating time [（12.63±8.03） min] of were shorter than that of TIVAP group [（33.84±11.74） min], and the average catheter length [（42.85±2.48） era] of PICC group were longer than that of TIVAP group [（11.76±0.70） cm] in and, the differences were statistically significant （/9 〈 0.01）. In both two groups, total success rate was 100.00%; in PICC group, one time success rate was 92.09% （128/139）, two times success rate was 6.47% （9/139）, three times suc- cess rate was 1.44% （2/139）, in TIVAP group, those were 88.57% （93/105）, 11.43% （12/105） respectively, the differ- ences between two groups were not statistically significant （/9 〉 0.05）. The incidence rate of eetopy （9.35%）, the inci- dence rate of phlebitis （9.35%） and the incidence ratecatheter obstruction （4.32%） of PICC group were higher than those of TIVAP （all were 0.00%）, the differences were statistically significant （P 〈 0.05）; the total incidence rate of complications of TIVAP group was than that of PICC group （9.52% vs 35.97%）, the differences were statistically signif- icant （P 〈 0.01）. Conclusion The incidence rate of complication of TIVAP was lower than that of PICC group, TIVAP was safer and more reliable than PICC, it can be an ideal deep venous channel in chemotherapy of breast cancer.

关 键 词：外周静脉置入中心静脉导管 植入式静脉输液港 乳腺肿瘤 

分 类 号：R73[医药卫生—肿瘤]