Abstract：
This retrospective study at Beijing Children\'s Hospital (2020-2023) analyzed surgical procedures and complications in 24 pediatric hemophilia patients undergoing Totally Implantable Venous Access Port (TIVAP) insertion, primarily in the right jugular vein (RJV). We detailed the surgical process, including patient demographics and intraoperative imaging use. The choice of the RJV for TIVAP placement was influenced by its larger diameter and superficial anatomical position, potentially reducing risks like thrombosis and infection. Our findings support the RJV as a safer alternative for port placement in pediatric patients, aligning with current literature. Statistical analysis revealed no significant correlation between complications and baseline characteristics like weight and diagnosis type. However, the length of hospital stay and implant brand were significant risk factors for catheter or port displacement and removal. The limited patient number may introduce bias, suggesting a need for further studies with larger samples. Despite a 14.7 %-33 % complication rate and 5 port removals, the advantages of TIVAP, including reliable venous access, reduced discomfort, and treatment convenience, were evident. Most complications improved with symptomatic treatment, and there were no deaths due to port-related complications, underscoring the impact of TIVAP on improving pediatric hemophilia treatment.
摘要：
这项在北京儿童医院（2020-2023年）进行的回顾性研究分析了24例接受完全植入式静脉接入端口（TIVAP）插入的小儿血友病患者的手术方式和并发症。主要在右颈静脉（RJV）。我们详细介绍了手术过程,包括患者的人口统计学和术中成像使用。TIVAP放置的RJV的选择受其较大直径和浅表解剖位置的影响，有可能降低血栓形成和感染等风险。我们的发现支持RJV作为儿科患者端口放置的更安全的替代方案，与当前文学保持一致。统计分析显示并发症与体重和诊断类型等基线特征之间没有显着相关性。然而,住院时间和植入物品牌是导管或端口移位和移除的显著危险因素.有限的患者数量可能会引入偏见，这表明需要对更大的样本进行进一步的研究。尽管有14.7%-33%的并发症发生率和5个端口移除，TIVAP的优势，包括可靠的静脉通路,减少不适,和治疗的便利性，很明显。大多数并发症通过对症治疗得到改善，没有因港口相关并发症而死亡，强调TIVAP对改善小儿血友病治疗的影响。
