植入式静脉输液港导管功能障碍原因的诊断及处理  

Diagnosis and treatment of the cause of catheter dysfunction of central verlous port access system

作　　者：王建新[1] 武中林[2] 苏金娜[1] 谢艳丽[1] 孙玉巧[1] 焦俊琴[1] 

机构地区：[1]河北医科大学第四医院乳腺中心,河北石家庄050011 [2]河北医科大学第四医院放射科,河北石家庄050011

出　　处：《河北医科大学学报》2016年第10期1192-1195,共4页Journal of Hebei Medical University

基　　金：河北省医学科学研究重点课题(ZD20140250)

摘　　要：目的探讨胸部X线检查及数字减影血管造影(digital subtraction angiography,DSA)在植入式静脉输液港(静脉港)导管功能障碍中的应用价值。方法静脉港导管功能障碍患者142例,采用胸部X线检查及DSA分析静脉港导管功能障碍原因,针对导管功能障碍原因给予相应处理,随访观察处理效果。结果 142例患者通过胸部X线检查及DSA明确了导管功能障碍原因98例(69.01%),其中导管纤维蛋白鞘形成51例、导管局部弯曲或折叠13例、导管断裂11例、Pinch-off综合征8例、导管内堵塞7例、导管末端位置异常5例、导管锁扣松动及脱落3例。对98例患者静脉港导管功能障碍原因给予相应处理后,提前摘除21例,继续使用77例。结论胸部X线检查是发现静脉港体内导管断裂最简单、有效的方法,纤维蛋白鞘形成是造成静脉港导管功能障碍的主要原因,胸部X线检查及DSA能够准确诊断静脉港导管功能障碍原因,值得临床推广应用。Objective To investigate the value of the chest X-ray and digital subtraction angiography（DSA） in central venous port access system（CVPAS） catheter dysfunction. Methods One hundred and forty-two cases of catheter dysfunction of CVPAS were studied. We analyzed the causes of catheter dysfunction by the chest X-ray and DSA, treated the causes and observed the effect. Results The causes of 98（69.01%） catheter dysfunction patients were found by DSA and chest X-ray in 142 cases of catheter dysfunction, including 51 cases of fibrin shell formation, 13 cases of catheter bend in the bodies, 11 cases of catheter fracture, 8 cases of Pinch-off sign, 7 cases of thrombus formation, 5 cases of abnormal location of end catheter and 3 cases of catheter fastener looseness or fallout. We treated the 98 cases of catheter dysfunction against these causes. 77 patients＂ CVPAS could continued to be used and 21 patients＂ CVPAS were removed. Conclusion The chest X-ray is the most simple and effective method to find the causes of catheter dysfunction of CVPAS.The main reason for CVPAS catheter dysfunction is fibrin shell formation. DSA and the chest X-ray can effectively evaluate the cause of CVPAS catheter dysfunction, which is worthy of clinical application.

关 键 词：输注 静脉内 导管功能障碍 血管造影术 

分 类 号：R452[医药卫生—治疗学]