上肢活动对不同径路输液港导管尖端位置的影响  

作　　者：李俊 黄则勇 

机构地区：[1]树兰(杭州)医院,310005

出　　处：《浙江临床医学》2021年第9期1287-1288,共2页Zhejiang Clinical Medical Journal

摘　　要：目的观察植入输液港后患者上肢活动对输液港导管管尖位置的影响。方法129例接受输液港植入且在术中有影像学资料的患者进行回顾性分析。按输液港植入的静脉通路分为右颈内静脉组(46例)和右锁骨下静脉组(83例)。术中均取体位一(平卧右上肢自然伸直靠近躯干)接受置港,妥善固定港体并拍片留档。术毕,取体位二(平卧,右上肢沿躯干的长轴线向头端伸展并尽量远离头顶)摄片留档。结果从体位一转变成体位二时,右颈内静脉组的输液港导管尖端向近心端移动,移动范围(3.86±3.38)mm;右锁骨下静脉组的输液港导管尖端向远心端移动,移动范围(12.93±5.6)mm。结论经右颈内静脉径路的输液港导管尖端的移动范围明显小于经右锁骨下静脉输液港导管尖端的移动范围,且两者方向相反。在输液港植入和术后X线胸片评估管尖位置时均应考虑患者上肢所处的位置及输液港导管的血管径路,以减少并发症的发生。Objective To observe the effect of upper limb movement on the tip position of catheter in infusion port after implantable Totally implantable venous access port(PORT).Methods Retrospective study of 129 patients who received PORT implantation and had intraoperative imaging data.Those patients were divided into right internal jugular vein group(46 cases)and right subclavian vein group(83 cases)according to the venous access of infusion port.All patients were placed in position 1(supine,right upper limb naturally extended close to the trunk)to receive PORT implantation,and the port body was properly fixed and photographed.At the end of the operation,all patients took position 2(lying on the back,extend the right upper limb to the head along the long axis of the trunk and try to stay away from the top of the head).Results The catheter tip of the PORT in the right internal jugular vein group moved to the proximal end of the heart,with a range of 3.86+3.38 mm,and that of the right subclavian vein group moved to the distal end,with a range of 12.93±5.6 mm.Conclusion The range of movement of the catheter tip through the right internal jugular vein is significandy smaller than that through the right subclavian vein,and the two directions are opposite.In order to reduce complications,the position of upper limb and the vascular path of the catheter should be considered in the evaluation of the tip of the tube after implantation and chest radiography.

关 键 词：上肢活动 输液港 导管尖端 位置 

分 类 号：R47[医药卫生—护理学]