[1]王黎明,张 帅,李 兴,等.植入式静脉输液港相关感染并发症风险因素分析[J].介入放射学杂志,2016,(11):949-953.
 WANG Li- ming,ZHANG Shuai,LI Xing,et al.Implantable venous access port- related infection: analysis of its risk factors[J].journal interventional radiology,2016,(11):949-953.
点击复制

植入式静脉输液港相关感染并发症风险因素分析 ()

PDF下载中关闭

分享到:

《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2016年11期
页码:
949-953
栏目:
血管介入
出版日期:
2016-11-25

文章信息/Info

Title:
Implantable venous access port- related infection: analysis of its risk factors
作者:
王黎明 张 帅 李 兴 宋 杰 蒋天鹏 许国辉 周 石
Author(s):
WANG Li- ming ZHANG Shuai LI Xing SONG Jie JIANG Tian- peng XU Guo- hui ZHOU Shi
Department of Interventional Radiology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou Province 550004, China
关键词:
【关键词】 植入式静脉输液港 肿瘤患者 感染 并发症
文献标志码:
A
摘要:
【摘要】 目的 探讨植入式静脉输液港(IVAP)应用患者发生导管相关感染并发症的风险因素。方法 收集2012年1月至2015年12月接受IVAP植入治疗的582例患者临床资料,对患者一般临床资料、细菌学资料、病情进展情况及IVAP相关感染发生率进行回顾性分析。结果 14例(2.4%,14/582)患者出现感染症状后取出IVAP,IVAP相关感染发生率为67例/千导管日。单因素分析显示住院患者(P=0.016)、恶性血液疾病患者(P=0.040)及接受姑息性化疗患者(P=0.022)感染率较高。多变量二元回归分析结果显示,恶性血液疾病及姑息性化疗患者发生感染的校正OR值分别为7.769(P=0.001)、4.863(P=0.003)。9例血液样本中细菌培养为阳性,最常见者为葡萄球菌(n=4)及念珠菌(n=2)。结论 恶性血液病和姑息性化疗,可能是引起IVAP相关感染的独立危险因素。

参考文献/References:

[1] Fischer L, Knebel P, Schroeder S, et al. Reasons for explantation of totally implantable access ports: a multivariate analysis of 385 consecutive patients[J]. Ann Surg Oncol, 2008, 15: 1124- 1129.
[2] Narducci F, Jean- Laurent M, Boulanger L, et al. Totally implantable venous access port systems and risk factors for complications: a one year prospective study in a cancer centre[J]. Eur J Surg Oncol, 2011: 913- 918.
[3] Biffi R, de Braud F, Orsi F, et al. Totally implantable central venous access ports for long- term chemotherapy. A prospective study analyzing complications and costs of 333 devices with a minimum follow- up of 180 days[J]. Ann Oncol, 1998, 9: 767- 773.
[4] Samaras P, Dold S, Braun J, et al. Infectious port complications are more frequent in younger patients with hematologic malignancies than in solid tumor patients[J]. Oncology, 2008, 74: 237- 244.
[5] Pandey N, Chittams JL, Trerotola SO. Outpatient placement of subcutaneous venous access ports reduces the rate of infection and dehiscence compared with inpatient placement[J]. J Vasc Interv Radiol, 2013, 24: 849- 854.
[6] Mermel LA, Allon M, Bouza E, et al. Clinical practice guidelines for the diagnosis and management of intravascular catheter- related infection: 2009 Update by the Infectious Diseases Society of America[J]. Clin Infect Dis, 2009, 49: 1- 45.
[7] Gebauer B, El- Sheik M, Vogt M, et al. Combined ultrasound and fluoroscopy guided port catheter implantation- high success and low complication rate[J]. Eur J Radiol, 2009, 69: 517- 522.
[8] Biffi R, Corrado F, de Braud F, et al. Long- term, totally implantable central venous access ports connected to a groshong catheter for chemotherapy of solid tumours: experience from 178 cases using a single type of device[J]. Eur J Cancer, 1997, 33: 1190- 1194.
[9] Brown DF, Muirhead MJ, Travis PM, et al. Mode of chemotherapy does not affect complications with an implantable venous access device[J]. Cancer, 1997, 80: 966- 972.
[10] Kock HJ, Pietsch M, Krause U, et al. Implantable vascular access systems: experience in 1500 patients with totally implanted central venous port systems[J]. World J Surg, 1998, 22: 12- 16.
[11] Lyon RD, Griggs KA, Johnson AM, et al. Long- term followup of upper extremity implanted venous access devices in oncology patients[J]. J Vasc Interv Radiol, 1999, 10: 463- 471.
[12] Wolosker N, Yazbek G, Nishinari K, et al. Totally implantable venous catheters for chemotherapy: experience in 500 patients[J]. Sao Paulo Med J, 2004, 122: 147- 151.
[13] Caers J, Fontaine C, Vinh- Hung V, et al. Catheter tip position as a risk factor for thrombosis associated with the use of subcutaneous infusion ports[J]. Support Care Cancer, 2005, 13: 325- 331.
[14] Ahn SJ, Kim HC, Chung JW, et al. Ultrasound and fluoroscopy- guided placement of central venous ports via internal jugular vein: retrospective analysis of 1254 port implantations at a single center[J]. Korean J Radiol, 2012, 13: 314- 323.
[15] Gapany C, Tercier S, Diezi M, et al. Frequent accesses to totally implanted vascular ports in pediatric oncology patients are associated with higher infection rates[J]. J Vasc Access, 2011, 12: 207- 210.
[16] 中心静脉通路上海协作组.完全植入式输液港上海专家共识[J]. 介入放射学杂志, 2015, 24: 1029- 1033.
[17] Lebeaux D, Zarrouk V, Leflon- Guibout V, et al. Totally implanted access port- related infections: features and management[J]. Rev Med Interne, 2010, 31: 819- 827.
[18] Teichgraeber UK, Kausche S, Nagel SN. Evaluation of radiologically implanted central venous port systems explanted due to complications[J]. J Vasc Access, 2011, 12: 306- 312.
[19] Aitken DR, Minton JP. The “pinch- off sign”: a warning of impending problems with permanent subclavian catheters[J]. Am J Surg, 1984, 148: 633- 636.
[20] Hinke DH, Zandt- Stastny DA, Goodman LR, et al. Pinch- off syndrome: a complication of implantable subclavian venous access devices[J]. Radiology, 1990, 177: 353- 356.
[21] Lebeaux D, Larroque B, Gellen- Dautremer JA, et al. Clinical outcome after a totally implantable venous access port- related infection in cancer patients a prospective study and review of the literature[J]. Medicine (Baltimore), 2012, 91: 309- 318.
[22] 林 群, 吴达娟, 胡桂芳, 等. 血液肿瘤患者经外周静脉置入中心静脉导管相关性感染的危险因素与预防措施[J]. 中华医院感染学杂志, 2015, 17: 3982- 3984.
[23] 周文锦, 俞 康, 郑翠苹, 等. 白血病患者血流感染危险因素分析[J]. 中华医院感染学杂志, 2013, 23: 5421- 5422.

相似文献/References:

[1]吴祥成,蔡茂德,苏炳光,等.伴有动脉硬化恶性肿瘤病人的股动脉穿刺插管治疗体会[J].介入放射学杂志,1998,(04):248.
[2]周沛林.“借鸡下蛋”开展介入放射学的体会[J].介入放射学杂志,1994,(01):59.
[3]黄荣丽,许秀芳,程永德,等.肿瘤供血动脉内灌注化疗并栓塞治疗的护理[J].介入放射学杂志,1995,(01):52.
[4]张彦收,刘 磊,耿翠芝,等.植入式静脉输液港导管断裂预防与处理[J].介入放射学杂志,2017,(08):702.
 ZHANG Yanshou,LIU Lei,GENG Cuizhi,et al.Catheter fracture of implantable central venous access port: its prevention and management[J].journal interventional radiology,2017,(11):702.
[5]仇晓霞,金光鑫,郭 艳,等.肿瘤患者上臂植入输液港并发上肢静脉血栓发生率及危险因素 [J].介入放射学杂志,2019,28(03):242.
 QIU Xiaoxia,JIN Guangxin,GUO Yan,et al.The incidence of venous thrombosis related to totally implantable access port in upper arm in cancer patients and its risk factors[J].journal interventional radiology,2019,28(11):242.
[6]蒋理添,陶立波,靳 勇,等.植入式给药装置对比外周静脉穿刺中心静脉置管应用于肿瘤患者长期静脉给药的卫生经济学分析 [J].介入放射学杂志,2019,28(06):547.
 JIANG Litian,TAO Libo,JIN Yong,et al.PORT versus PICC health economics analysis in cancer patients receiving long- term intravenous administration[J].journal interventional radiology,2019,28(11):547.

备注/Memo

备注/Memo:
(收稿日期:2016-04-01)
(本文编辑:边 佶)
更新日期/Last Update: 2016-11-22