發(fā)布時間：2018-05-01 11:38

  本文選題：乳腺癌 + 完全植入式靜脈輸液港　； 參考：《上海交通大學學報(醫(yī)學版)》2017年04期

【摘要】：目的·探討乳腺癌患者使用完全植入式靜脈輸液港(TIVAP)化療后導管相關附壁血栓形成的發(fā)生、危險因素及其治療情況。方法·190例留置TIVAP化療的乳腺癌患者,每療程化療前及取輸液港前行頸部血管彩色超聲檢查,觀察導管相關血栓形成的發(fā)生率、發(fā)生時間、危險因素及治療結果。結果·190例患者中,112例(58.9%)發(fā)生導管相關附壁血栓形成;其中無癥狀血栓形成108例(占56.8%),癥狀性血栓形成4例(占2.1%)。置管后21 d時,輸液港導管相關附壁血栓形成的發(fā)生率(22.1%)最高。年齡60歲的患者、乳腺癌臨床分期為III~IV級者以及TEC(多西紫杉醇聯(lián)合表阿霉素和環(huán)磷酰胺同期化療)化療方案是輸液港導管相關血栓形成的危險因素。經(jīng)皮下注射低分子肝素、口服蚓激酶腸溶膠囊或繼續(xù)口服阿司匹林的患者,血栓消失率的差異無統(tǒng)計學意義(P=0.743)。結論·乳腺癌化療患者使用輸液港導管相關癥狀性血栓發(fā)生率較低,但無癥狀性血栓形成的發(fā)生率較高,應給予重視。年齡、腫瘤分期和TEC化療方案是輸液港導管周圍附壁血栓形成的危險因素。
[Abstract]:Objective to investigate the incidence, risk factors and treatment of catheter-associated mural thrombus in breast cancer patients treated with TIVAP. Methods 190 patients with breast cancer treated with TIVAP were examined by color ultrasound before chemotherapy and before the infusion port. The incidence, time, risk factors and treatment results of catheter-related thrombosis were observed. Results among the 190 patients, 112 cases (58.9%) developed catheter-related mural thrombosis, of which 108 cases were asymptomatic thrombosis (56.8%) and 4 cases were symptomatic thrombosis (2.1%). 21 days after catheterization, the incidence of thrombus associated with catheterization was the highest (22. 1%). In patients aged 60 years, breast cancer patients with clinical stages of III~IV and Tac (docetaxel combined with epirubicin and cyclophosphamide chemotherapy) were risk factors of thromboembolism associated with infusion port ducts. There was no significant difference in thrombus disappearance rate in patients with subcutaneous injection of low molecular weight heparin (LMWH), oral wormkinase enteric-coated capsule (LKEC) or continuous oral aspirin (Aspirin). Conclusion the incidence of symptomatic thrombus associated with infusion conduit in breast cancer patients with chemotherapy is lower, but the incidence of asymptomatic thrombosis is higher. Age, tumor staging and TEC regimen were risk factors for thromboembolism around the catheter.
【作者單位】： 重慶醫(yī)科大學附屬第一醫(yī)院內(nèi)分泌乳腺外科;
【基金】：重慶市科學技術委員會基金(cstc2016shmszx0323)~~
【分類號】：R737.9

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