DSA引导下颈内、锁骨下及腋静脉入路输液港的临床应用  

Clinical application of DSA-guided infusion port implantation via internal jugular vein,subclavian vein and axillary vein

作　　者：郭新春[1] 徐新建 任冬青[1] 高峰[1] 黄祥忠[1] GUO Xinchun;XU Xinjian;REN Dongqing;GAO Feng;HUANG Xiangzhong(Department of Intervention,Jiangyin Municipal People’s Hospital,Jiangyin,Jiangsu Province 214400,China)

机构地区：[1]江阴市人民医院介入科,江苏江阴214400

出　　处：《介入放射学杂志》2023年第12期1211-1216,共6页Journal of Interventional Radiology

摘　　要：目的探讨DSA引导下颈内、锁骨下及腋静脉入路输液港的临床应用及安全性。方法 选取2016年3月28日至2018年6月28日在江阴市人民医院行DSA引导下静脉输液港植入术的肿瘤患者827例。根据患者输液港不同入路途径分为3组:经颈内静脉组(A组)125例,经锁骨下静脉组(B组)87例,经腋静脉组(C组)615例,比较3组患者的穿刺成功率及并发症发生情况。结果 DSA引导下A组首次穿刺成功率98.40%(123/125), B组穿刺成功率94.25%(82/87),C组穿刺成功率97.89%(602/615),差异有统计学意义(P<0.05);其中B组穿刺成功率低于C组,其余各组间差异无统计学意义(P>0.05)。对所有患者随访(15.56±2.91)个月(3~26个月),术后早期并发症总发生率为3.75%,A组为4.00%(5/125),B组为9.20%(8/87),C组为2.93%(18/615),其中B组发生率高于C组(P<0.016 7),各类并发症组间比较差异无统计学意义(P>0.05);术后远期并发症总发生率为4.72%(39/827), A组发生率为4.80%,B组发生率为14.95%,C组发生率为3.25%,B组并发症发生率高于A组及C组,差异有统计学意义(P<0.05)。各类并发症组间比较,B组导管断裂发生率高于C组,夹闭综合征仅发生于B组,差异有统计学意义(P<0.016 7),其余各类并发症组间差异无统计学意义(P>0.05)。非正常取港率为1.45%,A组3例,B组7例,C组2例,B组患者术后非正常取港率最高(8.05%),与C组比较差异有统计学意义(P<0.016 7)。结论 经腋静脉入路是一种安全、舒适、微创、高效的输液港植入方式,较经颈内静脉、经锁骨下静脉入路更能有效降低并发症发生率、术后非正常取港率,可作为临床应用的首选。Objective To investigate the clinical application and safety of DSA-guided infusion port implantation via internal jugular vein,subclavian vein and axillary vein.Methods A total of 827 patients with malignant tumors,who underwent DSA-guided intravenous infusion port implantation at the Jiangyin Municipal People’s Hospital of China between March 28,2016 and June 28,2018,were enrolled in this study.According to the used approach in the port implantation,the patients were divided into internal jugular vein group(group A,n=125),subclavian vein group(group B,n=87),and axillary vein group(group C,n=615).The success rate of puncturing and the incidence of complications were compared between each other among the three groups.Results The success rates of the DSA-guided first-time puncturing in group A,B and C were 98.40%(123/125),94.25%(82/87),and 97.89%(602/615)respectively,the difference was statistically significant(P<0.05);the success rate of puncturing in group B was lower than that in group C,and among the other groups there was no statistically significant difference(P>0.05).All patients were followed up for a mean period of(15.56±2.91)months(range of 3-26 months).The overall incidence of postoperative early complications was 3.75%,which in group A was 4.00%(5/125),in group B was 9.20%(8/87),and in group C was 2.93%(18/615),and the incidence of complications in group B was obviously higher than that in group C(P<0.0167).There was no statistically significant difference in the incidence of various complications between each other among the three groups(P>0.05).The overall incidence of postoperative long-term complications was 4.72%(39/827),which in group A was 4.80%,in group B was 14.95%,and in group C was 3.25%,and the incidence of complications in group B was strikingly higher than that in group A and group C, the differencewas statistically significant (P<0.05). Comparison of groups for the rates of various complications showed thatthe incidence of catheter fracture in group B was higher than that in group C,

关 键 词：DSA 颈内静脉 锁骨下静脉 腋静脉 输液港 

分 类 号：R472[医药卫生—护理学]