高级检索
    李天雄. 经右颈静脉完全植入式输注泵手术操作 与术后并发症相关性分析[J]. 徐州医科大学学报, 2019, 39(10): 758-762.
    引用本文: 李天雄. 经右颈静脉完全植入式输注泵手术操作 与术后并发症相关性分析[J]. 徐州医科大学学报, 2019, 39(10): 758-762.
    Correlation analysis of surgical procedures and postoperative complication on totally implantable[J]. Journal of Xuzhou Medical University, 2019, 39(10): 758-762.
    Citation: Correlation analysis of surgical procedures and postoperative complication on totally implantable[J]. Journal of Xuzhou Medical University, 2019, 39(10): 758-762.

    经右颈静脉完全植入式输注泵手术操作 与术后并发症相关性分析

    Correlation analysis of surgical procedures and postoperative complication on totally implantable

    • 摘要: 目的 分析经右颈静脉的完全植入式输注泵(TIAP)各手术操作细节与术后并发症的相关性分析。方法 回顾性分析我院2012年3月至2017年3月749例经右颈静脉TIAP植入的病例资料共749例。结果 术后并发症共36例:导管位置异常行二次手术调整共6例;管路堵塞共9例;TIAP导管相关感染共9例;继发静脉血栓6例;另有导管断裂或脱落4例、体件翻转2例及皮肤破溃1例。手术穿刺点定位采用术前B超定位,平均手术时间最短(49.2±11.9min),感染率最低(0.5%),小于术中B超定位组(58.9±22.2min,2.4%)。采用术中X光定位导管长度超过气管隆突平均4.64±0.43cm,较未行术中X光定位组(该平均值为3.44±1.12cm)更接近理想值6cm,全部6例管路位置异常行二次手术者均发生于未行术中X光定位组。管路堵塞组颈部穿刺点处导管转角弦长12.7±1.63mm,小于未堵塞组弦长19.8±3.14mm;术中确认管路可回抽血液,术后发生管路堵塞发生率0.65%,低于术中管路无回抽血液组的管路堵塞率(3.6%)。TIAP相关感染组手术时间(97.8±29.1min)长于无感染组(53.9±17.0min);血栓组手术时间(107±15.1min)长于无血栓组(54.0±17.2min)。结论 行术前B超定位穿刺点、行术中X光以调整导管位置、避免穿刺点处管路弧度过大、保证管路可回抽静脉血、缩短整体手术时间、避免导管损伤及注意体件固定可能减少经右颈内静脉输注泵植入的术后并发症风险。

       

      Abstract: Object To analyze the correlation between surgical procedures and postoperative complication on totally implantable access port (TIAP) via the right jugular vein. Methods A total of 749 patients ,who received TIAP via the right jugular vein at Beijing Shijitan Hospital from March 2012 to March 2017were included in the retrospective studycurrent The correlation between surgical procedures, catheter-related infection, abnormal catheter position and duct blockage and other post-operative complications were analyzed. Results There were 9 patients withTIAP-related infection, 6 patients who underwent secondary operation forabnormal catheter position, and 9 patients withduct blockage. Furthermore, there were also 4 cases of duct break, 2 cases of pump body reversal and 1 case of skin ulcerationAccording to Cox regression analysis, the post-operational infection risks were B-type ultrasonography fixed position during operation and extended operation timeThe average distanceof the catheter over the carina was (4.64±0.43) cm inpatients using X-ray for fixed position during surgery, which was statistically different from the average distance (3.44±1.12) cm of those without fixed position through X ray during surgery (P<0.05).

       

    /

    返回文章
    返回