可视化超声用于输液港植入全流程医护一体化管理  

Visual ultrasound for integrated management of whole process medical care of infusion port implantation

作　　者：王东林[1] 杨艳[2] 邱纯[3] 孙达统[3] 李赛[3] WANG Donglin;YANG Yan;QIU Chun;SUN Datong;LI Sai(Department of Ultrasound,Hainan General Hospital,Haikou 570311,China;Department of Dermatology,Hainan General Hospital,Haikou 570311,China;Department of Oncology,Hainan General Hospital,Haikou 570311,China)

机构地区：[1]海南省人民医院超声科,海南海口570311 [2]海南省人民医院皮肤科,海南海口570311 [3]海南省人民医院肿瘤内科,海南海口570311

出　　处：《中国介入影像与治疗学》2022年第8期472-475,共4页Chinese Journal of Interventional Imaging and Therapy

基　　金：海南省自然科学基金(821RC755)。

摘　　要：目的观察可视化超声用于输液港植入前、中、后全流程医护一体化管理的价值。方法选取133例于化学治疗前接受输液港植入的恶性肿瘤患者,其中106例经颈内静脉、27例经腋静脉植入;并观察植入前、中、后的临床及超声资料,分析超声对其全流程医护一体化管理的价值。结果133例患者中,术前超声发现一侧颈内静脉狭窄4例,一侧颈内静脉先天走行变异2例,一侧颈内静脉血栓2例。133例均成功一次性穿刺植入输液港。术后发现27例经腋静脉植入输液港中,导管异位于右侧颈内静脉1例;106例经颈内静脉植入输液港中,导管附壁血栓13例,导管折断并异位3例,注射座周围皮下软组织感染2例,注射座翻转1例;以相应措施干预后,患者一般情况均良好。结论可视化超声可于植入输液港前评估拟穿刺血管、于植入中实时引导穿刺、于植入后密切监控,实现输液港植入全流程医护一体化管理。Objective To observe the value of visual ultrasound for integrated management of whole process medical care before, during and after infusion port implantation. Methods Totally 133 patients with malignant tumors who received infusion port implantation before chemotherapy were enrolled, including 106 cases through internal jugular vein and 27 cases through axillary vein. The clinical and ultrasonic data before, during and after implantation were observed, and the value of ultrasound for integrated management of whole process medical care was analyzed. Results Among 133 cases, preoperative ultrasound detected 4 cases with unilateral internal jugular vein stenosis, 2 cases with congenital variation of unilateral internal jugular vein and 2 cases with unilateral internal jugular vein thrombosis. All 133 cases successfully completed infusion port implantation at one time. Among 27 cases that implanted through axillary vein, catheter located in the right internal jugular vein was found in 1 case after implanted. Among 106 cases implanted through internal jugular vein, catheter wall thrombosis was detected in 13 cases, catheter broken and ectopic in 3 cases, subcutaneous soft tissue infection around the injection seat in 2 cases and injection seat turnover after implanted in 1 case. The above patients were generally in good condition after corresponding intervention measures. Conclusion Visual ultrasound could evaluate the punctured blood vessels before, real time guide puncture during and closely monitor after infusion port implantation, being assistant to realize integrated management of whole process medical care of infusion port implantation.

关 键 词：颈静脉 腋静脉 超声检查 输液港 

分 类 号：R730.53[医药卫生—肿瘤] R445.1[医药卫生—临床医学]