成年癌症患者立即使用完全植入式静脉通道的安全性:一项回顾性单中心研究。

Jisu Lee, Sung Mo Hur, Zisun Kim, Cheol Wan Lim
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摘要

目的:全植入式静脉通道(TIVAPs)可长期用于安全的静脉给药。TIVAP并发症包括导管相关感染、静脉血栓形成、外渗、TIVAP迁移和疼痛。移植后第一次化疗的时间与并发症的关系是有争议的。本研究旨在探讨立即使用TIVAPs的安全性及其并发症的相关危险因素。方法:2016年1月至2018年12月,305例患者(中位年龄53岁;我们纳入了在我们机构接受TIVAP安置的256名妇女。化疗在植入后2天内进行。回顾性分析患者的临床资料,探讨TIVAPs的置管天数和并发症。结果:总体而言,305例患者在57,324天内接受了评估(中位数为168天;四分位数范围,105)。放置和首次使用tivap的中位间隔为0.98天。总发病率为2.95%。9例患者出现9例并发症,包括tivap相关感染(4例)、疼痛(2例)、端口阻塞(1例)、血栓形成(1例)、疤痕不愈合(1例),其中5例需要切除端口(1.64%)。并发症发生前的中位置管天数为61天(范围:10-457天;四分位数范围,51)。植入7天内无并发症发生。在Cox比例风险模型中,体重指数是tivap相关并发症的独立危险因素(多变量分析:风险比为1.221;95%置信区间为1.054 ~ 1.414;P = 0.008)。结论:本研究建议在植入后2天内立即给予化疗,并长期安全使用TIVAPs。
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Safety of immediate use of totally implantable venous access ports in adult patients with cancer: a retrospective single-center study.

Purpose: Totally implantable venous access ports (TIVAPs) can be used long-term for safe administration of intravenous drugs. TIVAP complications include catheter-related infections, venous thrombosis, extravasation, TIVAP migration, and pain. The relationship between the timing of the first chemotherapy administration after port implantation and complications is controversial. This study aimed to investigate the safety of immediate use of TIVAPs and the associated risk factors for complications.

Methods: Between January 2016 and December 2018, 305 patients (median age, 53 years; 256 women) who underwent TIVAP placement at our institution were included. Chemotherapy was administered within 2 days of implantation. A retrospective analysis of patients' clinical data was performed to investigate catheter days and complications of TIVAPs.

Results: Overall, 305 patients were evaluated over 57,324 catheter days (median, 168 catheter days; interquartile range, 105). The median interval between placement and first use of TIVAPs was 0.98 days. The overall morbidity rate was 2.95%. Nine complications occurred in nine patients, including TIVAP-related infection (4), pain (2), port occlusion (1), thrombosis (1), and scar disunion (1), of which five required port removal (1.64%). The median number of catheter days before complications occurred was 61 (range, 10-457 days; interquartile range, 51). No complications occurred within 7 days of implantation. Body mass index was an independent risk factor for TIVAP-related complications in the Cox proportional hazards model (multivariable analysis: hazard ratio, 1.221; 95% confidence interval, 1.054-1.414; P=0.008).

Conclusion: This study suggests the safe long-term use of TIVAPs following their immediate chemotherapy administration within 2 days of implantation.

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