完全植入式静脉输液港在乳腺癌患者术后治疗中的应用  

The application of implantable venous access ports in management of postoperative breast cancer patients

作　　者：刘志敏[1] 钟源[1] 江学庆[1] 石朋飞[1] 李洋[1] 

机构地区：[1]湖北省武汉市中心医院甲状腺乳腺外科,430000

出　　处：《中华内分泌外科杂志》2016年第2期148-151,共4页Chinese Journal of Endocrine Surgery

摘　　要：目的探索和分析完全植入式静脉输液港在乳腺癌患者术后的安装使用及维护的经验，为后续的使用提供最佳策略。方法回顾性分析武汉市中心医院自2011年3月至2014年6月期间接受完全植入式静脉输液港植入的乳腺癌患者．对安装及使用过程中出现的相关并发症进行的处理和总结。结果468例均为女性，其中451例行右侧颈内静脉穿刺植入，15例行右侧锁骨下静脉穿刺植入，2例行左侧颈内静脉穿刺植入。经右侧颈内静脉植入患者，置管长度平均12．8（12—15）cm。30例出现早期并发症（6-4％），主要包括穿刺困难16例、误穿动脉5例、液体渗漏2例、输液和回抽血困难2例、心前区不适及心律失常5例。3例出现晚期并发症（0．6％）。包括导管感染1例、导管脱落1例和切口裂开1例。结论完全植入式静脉输液港是一种安全稳定的静脉输液装置，由专业的团队针对个体选择合适的植入方式及植入长度，同时在出现相关并发症后早期合理的处理及跟踪维护对其正常使用至关重要。Objective To investigate and analyze the experience of planting and maintaining implantable venous access ports（IVAP） in management of post-operative breast cancer patients. Methods Breast cancer pa- tients receiving IVAP after surgery from Mar. 2011 to Jun. 2014 were retrospectively analyzed. The relative com- plications were documented and summarized during implanting operation. Results 468 patients received IVAP, among whom 451 patients underwent piercing implantation via right internal jugular vein, 15 patients underwent piercing implantation via right subclavian vein, and 2 patients underwent piercing implantation via left internal jugular vein. The mean cathetering length was 12.8 cm for patients receiving 1VAP via right internal jugular vein, ranging from 12 to 15 cm. Thereinto, 30（6.4%） patients experienced shot-term complications including 16 cases of puncture difficulty, 5 cases of accidental arterial puncture, 2 cases of extravasation, 2 cases of blood aspiration dificulty and 5 cases of arrhythmia. Three cases had long-term complications as the following： one case of catheter-related infection, one case of catheter lost, and one case of incision rupture. Conclusions IVAP is a safe and effective intravenous infusion device. It is crucial to choose individualized implanting access and length by professional surgical team.

关 键 词：完全植入式静脉输液港 乳腺癌 

分 类 号：R473.73[医药卫生—护理学]