完全植入式输液港植入术后导管头端异位介入复位6例  

Interventional restoration for malposition of catheter tip after the placement of totally implantable access port: preliminary results in 6 cases

作　　者：潘天帆 高峰 任冬青 郭新春 黄祥忠 PAN Tianfan;GAO Feng;REN Dongqing;GUO Xinchun;HUANG Xiangzhong(Department of Interventional Radiology,Jiangyin Municipal People’s Hospital,Jiangyin,Jiangsu Province 214400,China)

机构地区：[1]江阴市人民医院(东南大学附属江阴医院)介入科,江苏江阴214400

出　　处：《介入放射学杂志》2023年第3期251-254,共4页Journal of Interventional Radiology

摘　　要：目的 探讨完全植入式输液港(TIAP)植入术后导管头端异位的原因、确诊方法及处理措施。方法 回顾性分析2016年3月至2021年12月在江阴市人民医院接受TIAP植入术的2 234例患者临床资料。记录术后导管头端异位发生率、发生时间,分析原因,评价处理措施。结果 2 234例患者均成功植入TIAP。6例(0.27%)术后发生导管头端异位,均经影像学检查证实。6例中男4例,女2例,年龄(61.5±18.2)岁,26~79岁。TIAP植入至发现导管头端异位时间为18~119 d,主要原因为导管位置过浅、剧烈咳嗽、肢体活动和肥胖。采用介入猪尾导管勾挂法,6例导管头端异位均获成功复位。1例复位后再次异位,后取出TIAP并经锁骨上入路穿刺锁骨下静脉重新植入TIAP,未再出现异位。结论 TIAP植入术后导管头端异位发生率低,易于确诊和复位。介入猪尾导管勾挂法复位简便、安全,但仍需警惕因导管头端异位所导致的不良后果。Objective To discuss the causes,diagnosis and treatment measures of catheter tip malposition after the placement of totally implantable access port(TIAP).Methods The clinical data of a total of 2234 patients,who underwent TIAP placement at the Jiangyin Municipal People's Hospital of China between March 2016 and December 2021,were retrospectively analyzed.The incidence of post-TIAP catheter tip malposition and the time of its occurrence were recorded,the causes were analyzed,and the treatment measures were evaluated.Results Successful implantation of TIAP was accomplished in all the 2234 patients.Post-TIAP catheter tip malposition,which was confirmed by imaging examination,occurred in 6 patients(0.27%),including 4 males and 2 females with a mean age of(61.5±18.2)years(range of 26-79 years).The interval from TIAP implantation to the discovery of catheter tip malposition was within 18-119 days.The main causes of catheter tip malposition included too shallow insertion of catheter into superior vena cava,severe coughing,vigorous limb movement and obesity.By using pigtail catheter hook technique,successful restoration of catheter tip malposition was achieved in all 6 patients.Recurrence of catheter tip malposition occurred in one patient,the implanted TIAP had to be removed and re-implantation of TIAP through subclavian vein puncture via supraclavicular approach was carried out,and thereafter the catheter tip malposition didn't occur again.Conclusion Clinically,the incidence of post-TIAP catheter tip malposition is very low,and this disorder is easily to be diagnosed and restored.The interventional pigtail catheter hook method is technically simple and clinically safe.However,high attention should be paid to the adverse consequences caused by catheter tip malposition.

关 键 词：完全植入式输液港 异位 猪尾导管 复位 

分 类 号：R472[医药卫生—护理学]