[1]李晨晨,胡 明,褚 珺,等.外周穿刺中心静脉导管与完全植入式静脉输液港在儿童肿瘤的临床比较 [J].介入放射学杂志,2018,27(08):735-739.
 LI Chenchen,HU Ming,CHU Jun,et al.Peripherally- inserted central venous catheter vs totally- implantable venous access port in treating pediatric tumors: comparison of clinical efficacy[J].journal interventional radiology,2018,27(08):735-739.
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外周穿刺中心静脉导管与完全植入式静脉输液港在儿童肿瘤的临床比较
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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
27
期数:
2018年08期
页码:
735-739
栏目:
肿瘤介入
出版日期:
2018-08-25

文章信息/Info

Title:
Peripherally- inserted central venous catheter vs totally- implantable venous access port in treating pediatric tumors: comparison of clinical efficacy
作者:
李晨晨 胡 明 褚 珺 陈其民 蔡金晶
Author(s):
LI Chenchen HU Ming CHU Jun CHEN Qimin CAI Jinjing.
Department of Pediatric Surgery, Affiliated Shanghai Children′s Medical Center, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
关键词:
【关键词】 儿童 肿瘤 中心静脉置管术 经外周穿刺中心静脉导管 完全植入式静脉输液港 并发症
文献标志码:
A
摘要:
【摘要】 目的 探讨肿瘤患儿最为安全、有效的长期中心静脉导管留置方式。方法 回顾性研究2006年1月至2017年12月共1 047例长期中心静脉导管留置的肿瘤患儿,其中经外周穿刺中心静脉导管(PICC)436例,完全植入式静脉输液港(TIVAP)611例。比较两组患儿的近、远期并发症,并作统计学分析。结果 PICC组并发症发生率21.2%(98/463):近期并发症 32例(导管末端位置异常10例,穿刺处机械性静脉炎17例,局部皮下血肿5例);远期并发症66例(导管阻塞及血栓形成25例、导管相关性感染20例,导管移位滑脱 16例,导管渗漏断裂5例)。TIVAP组并发症发生率5.6%(34/611):近期并发症13例(血肿3例,误穿动脉9例,夹闭综合征1例);远期并发症21例(导管阻塞及血栓形成3例、导管相关性感染13例,导管或泵体破裂渗漏3例,导管与血管壁粘连取出困难2例)。TIVAP组并发症发生率明显低于PICC组(P<0.05)。结论 TIVAP具有并发症少,安全耐用的优势。PICC则置入简便、无需麻醉,费用低,置入后能即刻使用的特点。两者均能显著减少患儿的疼痛并提高生活质量。故对于儿童肿瘤患儿,应根据个体化差异灵活选择合适的中心静脉导管留置方式。

参考文献/References:

[1] 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.
[2] 褚 珺, 陈其民, 吴晔明. 植入性中心静脉通道装置(Port)在肿瘤患儿中的应用[J]. 中华小儿外科杂志, 2009, 30: 741- 744.
[3] Giordano P, Saracco P, Grassi M, et al. Recommendations for the use of long- term central venous catheter(CVC) in children with hemato- oncological disorders: management of CVC- related occlusion and CVC- related thrombosis. On behalf of the coagulation defects working group and the supportive therapy working group of the Italian Association of Pediatric Hematology and Oncology(AIEOP)[J]. Ann Hematol, 2015, 94: 1765- 1776.
[4] Fang S, Yang J, Song L et al. Comparison of three types of central venous catheters in patients with malignant tumor receiving chemotherapy[J]. Patient Prefer Adher, 2017, 11: 1197- 1204.
[5] Yildizeli B, Lacin T, Batirel HF, et al. Complications and management of long- term central venous access catheters and ports[J]. J Vasc Access, 2004, 5: 174- 178.
[6] Kim HJ, Yun J, Kim HJ, et al. Safety and effectiveness of central venous catheterization in patients with cancer: prospective observational study[J]. J Korean Med Sci, 2010, 25: 1748- 1753.
[7] Loewenthal MR, Dobson PM, Starkey RE, et al. The peripherally inserted central catheter(PICC): a prospective study of its natural history after cubital fossa insertion[J]. Anaesth Intensive Care, 2002, 30: 21- 24.
[8] Timsit JF. What is the best site for central venous catheter insertion in critically in patients?[J]. Crit Care, 2003, 7: 397- 399.
[9] Canfora A, Mauriello C, Ferronetti A, et al. Efficacy and safety of ultrasound- guided placement of central venous port systems via the right internal jugular vein in elderly oncologic patients: our single- center experience and protocol[J]. Aging Clin Exp Res, 2017, 29: 127- 130.
[10] 胡 明, 褚 珺, 陈其民, 等. 婴幼儿超声辅助下颈内静脉穿刺植入完全植入式静脉输液港评价[J]. 介入放射学杂志, 2017, 26: 684- 687.
[11] 仇晓霞, 金光鑫, 郭 燕, 等. 超声引导下上臂完全植入式输液港置入临床应用[J]. 介入放射学杂志, 2017, 26: 689- 694.
[12] Povoski SP. A prospective analysis of the cephalic vein cutdown approach for chronic indwelling central venous access in 100 consecutive cancer patients[J]. Ann Surg Oncol, 2000, 7: 496- 502.
[13] Cowl CT, Weinstock JV, AI- Jurf A, et al. Complications and cost associated with parenteral nutrition delivered to hospitalized patients through either subclavian or peripherally inserted central catheters[J]. Clin Nutr, 2000, 19: 237- 243.
[14] Viale P, Pagani L, Petrosillo N, et al. Antibiotic lock- technique for the treatment of catheter- related bloodstream infections[J]. J Chemother, 2003, 15: 152- 156.
[15] Svoboda P, Barton RP, Barbarash OL, et al. Recombinant urokinase is safe and effective in restoring patency to occluded central venous access devices: a multiple- center, international trial[J]. Crit Care Med, 2004, 32: 1990- 1996.
[16] Kumwenda M, Dougherty L, Spooner H, et al. Managing dysfunctional central venous access devices: a practical approach tourokinase thrombolysis[J]. Br J Nurs, 2018 27: S4- S10.
[17] Viart H, Combe C, Martinelli T, et al. Comparison between implantation costs of peripherally inserted central catheter and implanted subcutaneous ports[J]. Ann Pharm Fr, 2015, 73: 239- 244.

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备注/Memo

备注/Memo:
(收稿日期:2018-02-28)
(本文编辑:俞瑞纲)
更新日期/Last Update: 2018-08-17