Abstract:

Comparative study on two different implantable vascular access devices: An analysis of 2897 cases        ZHOU Tao, TANG Tian-tian, LI Yun-tao, et al. Breast Center, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
Corresponding author: GENG Cui-zhi, E-mail: cuizhigeng@hotmail.com
Abstract    Objective    To compare the subclavian venipuncture with internal jugular venipuncture applied in the operation of implantable vascular access devices. Methods    The different operative techniques and methods of 2897 adult cases of implantable vascular access devices performed between December 2008 and March 2014 in the Fourth Hospital of Hebei Medical University were analyzed retrospectively. The complications of two surgical techniques were compared. Results    In 2897 cases, a total of 2718 (93.82%) cases were performed internal jugular venipuncture including 1222 cases of left internal jugular venipuncture and 1496 cases of right internal jugular venipuncture. There were 179 (6.18%) cases of subclavian vein puncture including 77 cases of left subclavian vein puncture and 102 cases of right subclavian vein puncture. The achievement rate of internal jugular venipuncture(98.68%) was higher than that in the subclavian venipuncture(88.83%) significantly (χ2=80.814, P=0.000). The implant complications occurred in 25 cases (0.86%，25/2897). The incidence of pneumothorax in subclavian venipuncture (4.47%，8/179) was higher than that in the internal jugular venipuncture significantly (0.04%，1/2718) (χ2=106.54，P=0.000). The incidence of pneumothorax between the left and right subclavian venipuncture had no difference(7.79% vs. 1.96%，P=0.077）. The incidences of hemothorax between left and right side had no difference (0.08% vs. 0.07%，P=0.697) and there was no death in the group. Conclusion   The implantable vascular access device is a latest technology for the cases requiring long-term intravenous infusion. The internal jugular venipuncture is a safe and effective technique with relatively low incidence of complications.

Key words: implantable vascular access device, subclavian vein, internal jugular vein

摘要：

目的    探讨锁骨下静脉与颈内静脉两种不同穿刺方式植入式静脉输液港的对比研究。方法    回顾性分析2008年12月至2014年3月河北医科大学第四医院2897例成人植入式静脉输液港锁骨下静脉与颈内静脉穿刺植入的操作方法，并比较两种植入术式的相关并发症。结果    2897例中经颈内静脉穿刺共2718例（93.82%），其中经左颈内静脉穿刺1222例，经右颈内静脉穿刺1496例；经锁骨下静脉穿刺179例（6.18%），其中经左锁骨下静脉穿刺77例，经右锁骨下静脉穿刺102例。颈内静脉穿刺成功率（98.68%）明显高于锁骨下静脉穿刺成功率（88.83%）（χ2=80.814，P=0.000）。发生植入时并发症25例（0.86%，25/2897），锁骨下静脉穿刺气胸发生率（4.47%，8/179）明显高于颈内静脉穿刺气胸发生率（0.04%，1/2718）（χ2=106.54，P=0.000）。左右侧锁骨下静脉穿刺气胸发生率差异无统计学意义（7.79% vs. 1.96%，P=0.077）。左右侧锁骨下静脉穿刺血胸发生率差异无统计学意义（0.08% vs. 0.07%，P=0.697）。全组无死亡病例发生。结论    植入式静脉输液港是临床需要长期静脉输液的常用技术。颈内静脉穿刺植入为一项安全、有效、并发症发生率相对较低的技术。

关键词: 植入静脉输液港, 锁骨下静脉, 颈内静脉