引言在这项回顾性研究中,分析成人肿瘤患者在超声和透视引导下经颈内静脉移植的安全性和并发症发生率。材料与方法回顾性分析2017年1月1日至2019年12月31日36个月期间在三级肿瘤-抗癌医院植入799名成人肿瘤患者的87个端口。数据采集一直持续到2020年12月31日。所有手术均由两名专业的介入放射科医师在超声和超声引导下进行。静脉通路是通过颈内静脉。导管天数(所有患者在移除之前对端口进行维护的总天数,死亡,或2020年12月31日),技术成功率,根据介入放射学报告和患者病历评估并发症发生率.关于患者的多因素分析,如年龄,性别,体重指数(BMI),婚姻状况,教育水平,癌症类型,插入的一侧,颈内静脉直径,糖尿病,抗凝剂/抗血小板,植入的目的,和导管材料对并发症的风险进行了研究。结果共观察到369,329天的导管维护(457.7±345.0)。技术成功率为99.9%,共发生85例(10.5%)并发症,其中24例(28.2%)出现早期(<30天),其余61例(71.8%)出现晚期(>30天)并发症.具体来说,28例(3.5%)导管相关性血栓形成(CRT),27(3.4%)与感染有关,17(2.1%)是机械性并发症(16个纤维蛋白鞘形成和一个导管阻塞),六个(0.7%)与导管迁移有关,四个(0.5%)与切口愈合问题有关,其余3例(0.4%)与缺血性皮肤坏死有关。由于并发症,取出了47个(5.8%)端口。在多变量分析中,癌症类型被发现是并发症发展的危险因素。此外,有迹象表明恶性血液病与感染有关.结论在超声和透视引导下通过颈内静脉放置港口是一种安全的手术。早期和晚期并发症发生率低。
Introduction In this retrospective study, the safety and complication rates of port implantations via the internal jugular vein under ultrasound and fluoroscopy guidance in adult oncology patients were analyzed. Material and methods Eight hundred seven ports implanted in 799 adult oncology patients at a tertiary Oncology-Anticancer Hospital during a 36-month period from January 1, 2017 to December 31, 2019 were retrospectively reviewed. Data acquisition was obtained until December 31, 2020. All procedures were performed by two specialized interventional radiologists under ultrasound and fluoroscopy guidance. The vein access was via the internal jugular vein. Catheter days (the total number of days of maintenance of the port by all of the patients until removal, death, or December 31, 2020), technical success rates, and complication rates were evaluated based on the interventional radiological reports and patient medical records. Multivariate analysis regarding patients such as age, sex, body mass index (BMI), marital status, educational level, cancer type, side of insertion, diameter of internal jugular vein, diabetes, anticoagulants/antiplatelets, purpose of implantation, and catheter material as to the risk of complications was conducted. Results A total of 369,329 catheter maintenance days were observed (457.7±345.0). The technical success rate was 99.9%, and a total of 85 (10.5%) complications occurred, of which 24 (28.2%) occurred early (<30 days) and the remaining 61 (71.8%) were late (>30 days) complications. Specifically, 28 (3.5%) were catheter-related thrombosis (CRT), 27 (3.4%) related to infection, 17 (2.1%) were mechanical complications (16 fibrin sheath formation and one catheter occlusion), six (0.7%) related to catheter migration, four (0.5%) related to incision healing problems, and the remaining three (0.4%) related to ischemic skin necrosis. Forty-seven (5.8%) ports were removed due to complications. On multivariate analysis, cancer type was found as a risk factor for the development of a complication. Additionally, there was an indication that hematologic malignancy is related to infection. Conclusion Placement of ports via the internal jugular vein under ultrasound and fluoroscopy guidance is a safe procedure, with low rates of early and late complications.