發(fā)布時(shí)間：2019-04-28 15:27

【摘要】：目的探討超聲導(dǎo)引下上臂完全植入式輸液港(TIAP)植入的安全性、技術(shù)可行性及相關(guān)并發(fā)癥。方法選擇2014年2月至2016年12月接受上臂植入TIAP患者642例,其中男407例(63.4%),女235例(36.6%),年齡11~89(58.29±4.33)歲。采用超聲導(dǎo)引下Seldinger置管技術(shù),于上臂植入TIAP。結(jié)果 642例患者均植入上臂TIAP,首次植入成功率99.53%(639/642),3例首次穿刺失敗,第2次植入成功。隨訪155 302個(gè)導(dǎo)管日,共發(fā)生并發(fā)癥58例(9.0%),其中近期并發(fā)癥9例,遠(yuǎn)期并發(fā)癥49例;TIAP相關(guān)感染28例(4.4%),導(dǎo)管靜脈血栓7例(1.1%),囊袋出血3例(0.4%),TIAP體翻轉(zhuǎn)3例(0.4%),皮膚裂開(kāi)1例(0.2%),導(dǎo)管堵塞2例(0.3%),導(dǎo)管繼發(fā)移位4例(0.6%),導(dǎo)管相關(guān)上肢運(yùn)動(dòng)受限7例(1.1%),上肢靜脈回流障礙2例(0.3%),正中神經(jīng)損傷1例(0.2%),無(wú)相關(guān)死亡事件發(fā)生。結(jié)論超聲導(dǎo)引下經(jīng)皮穿刺上臂植入TIAP技術(shù)安全有效,創(chuàng)傷小,并發(fā)癥發(fā)生率低,值得臨床推廣應(yīng)用。
[Abstract]:Objective to investigate the safety, technical feasibility and related complications of (TIAP) implantation in a fully implanted upper arm infusion port under ultrasound guidance. Methods from February 2014 to December 2016, 642 patients (male 407 (63.4%), female 235 (36.6%), age 11 / 89 (58.29 鹵4.33) years) with upper arm implantation of TIAP were selected. Ultrasound-guided Seldinger tube placement technique was used to implant TIAP. into the upper arm. Results the success rate of the first implantation of upper arm TIAP, was 99.53% (639 / 642) in all the 642 patients. The first puncture failed in 3 cases and the second implantation was successful in 3 cases. During the follow-up of 155,302 catheter days, 58 cases (9.0%) had complications, including 9 cases of short-term complications and 49 cases of long-term complications. TIAP-associated infection was found in 28 cases (4.4%), catheter venous thrombosis in 7 cases (1.1%), cystic hemorrhage in 3 cases (0.4%), tip body reversal in 3 cases (0.4%), skin dehiscence in 1 case (0.2%). Catheter occlusion was found in 2 cases (0.3%), secondary catheter displacement in 4 cases (0.6%), catheter-related upper limb movement restriction in 7 cases (1.1%), venous reflux disorder in 2 cases (0.3%), and catheter-related upper limb movement restriction in 7 cases (1.1%). The median nerve injury occurred in 1 case (0.2%), and there was no related death event. Conclusion Percutaneous transhepatic TIAP implantation under ultrasound guidance is safe and effective with little trauma and low incidence of complications. It is worth popularizing and applying in clinical practice.
【作者單位】： 上海交通大學(xué)醫(yī)學(xué)院附屬仁濟(jì)醫(yī)院腫瘤科;上海交通大學(xué)醫(yī)學(xué)院附屬仁濟(jì)醫(yī)院腫瘤介入科;
【基金】：上海市衛(wèi)生計(jì)生委科研項(xiàng)目(20134092) 上海交通大學(xué)醫(yī)學(xué)院科技基金(Jyh1609)
【分類(lèi)號(hào)】：R472

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