超声和数字减影血管造影双引导置入静脉输液港在肿瘤患者中的应用  

Application of venous port access based on dual-guided ultrasound and digital subtraction angiography in oncology patients

作　　者：马波[1] 李宗明[1] 周子鹤 李亚华[1] 吴昆鹏 王洋[1] 李晓[1] 任克伟[1] MA Bo;LI Zongming;ZHOU Zihe;LI Yahua;WU Kunpeng;WANG Yang;LI Xiao;REN Kewei(Department of Interventional Radiology,the First Affiliated Hospital of Zheng zhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院放射介入科,河南郑州450052

出　　处：《实用放射学杂志》2023年第5期805-808,共4页Journal of Practical Radiology

基　　金：河南省自然科学基金青年基金项目(222300420349)。

摘　　要：目的探讨超声和数字减影血管造影(DSA)双引导置入静脉输液港的可行性和优势。方法回顾性分析30例肿瘤患者应用超声和DSA双引导置入静脉输液港的资料。记录肿瘤类型、置管位置、操作时间、穿刺成功率、置管成功率、血管内导管长度、置管总长度、导管留置时间、随访方式、近期并发症和远期并发症的情况。总结超声和DSA双引导的优势。结果30例患者中左侧颈内静脉置管2例,右侧锁骨下静脉置管1例,其余27例均为右侧颈内静脉置管;置管操作时间26~41 min,平均(30.5±3.1)min;血管穿刺1针穿刺成功29例,成功率96.7%,1例患者2针穿刺成功;1次置管成功率100%;导管留置时间3~207 d,平均(117.5±61.3)d;血管内导管长度11.6~20.2 cm,平均(16.4±2.1)cm,置管总长度18.2~28.9 cm,平均(25.2±2.8)cm;近期并发症:1例术中出现室上性心动过速,1例于术后出现皮下渗血;远期并发症:1例出现无创蝶翼针推注顺利,回抽无血,无其他并发症发生。1例上腔静脉压迫综合征的患者先置入支架开通上腔静脉,再经右侧颈内静脉置入输液港。结论超声和DSA双引导置入静脉输液港成功率高,并发症少,且可拓宽输液港的适应证。Objective To investigate the feasibilities and advantages of venous port access based on dual-guided ultrasound and digital subtraction angiography(DSA).Methods A total of 30 oncology patients with the application of ultrasound and DSA dualguided placement of venous port access were analyzed retrospectively.The tumor types,placing position,operating time,puncture success rate,placing success rate,intravascular catheter length,total placing length,keeping catheter time,following-up method,short-term complications,and long-term complications were all further recorded,respectively.The advantages of duel-guided based on ultrasound and DSA were finally summarized.Results Of all 30 cases,there were 2 cases implanted into the left internal jugular vein,1 case implanted into the right subclavian vein,and the other 27 cases implanted into the right internal jugular vein.Placing operation time was 26-41 minutes,average(30.5±3.1)minutes.A total of 29 patients were successfully punctured at first attempt,with a success rate of 96.7%.Only 1 patient was successfully punctured at second attempt.The success rate of first attempt catheterization was 100%.Keeping catheter time was 3-207 days,average(117.5±61.3)days,intravascular catheter length was 11.6-20.2 cm,average(16.4±2.1)cm,and total placing length was 18.2-28.9 cm,average(25.2±2.8)cm,respectively.During operation,1 patient suffered supraventricular tachycardia,while 1 patient suffered subcutaneous bleeding after operation.In 1 patient,the needle injection was successful but no blood reflux when pump syringe with no complications.In addition,1 patient with superior vena cava compression syndrome was successfully managed by stent implantation and venous port access placed through the right internal jugular vein.Conclusion Duel-guided ultrasound and DSA for placing venous port access can achieve a high success rate with few complications to broaden the indications of the venous port.

关 键 词：超声 数字减影血管造影 静脉输液港 肿瘤 

分 类 号：R445.1[医药卫生—影像医学与核医学] R814.43[医药卫生—诊断学] R730.8[医药卫生—临床医学]