| 摘要: |
| 目的 探讨儿童完全植入式静脉输液港（以下简称输液港）植入术中经胸心脏超声辅助定位导管尖端的效果。方法 回顾性分析我院2015年3月至2020年6月接受输液港植入术的200例恶性肿瘤患儿的临床资料。根据输液港导管尖端定位方式将患儿分为X线片定位组（105例）和超声定位组（95例）。统计分析两组患儿的一般资料、手术时长、导管尖端位置理想率及术后并发症发生情况。结果 两组患儿的年龄、性别、身高、体重、BMI、肿瘤类型差异均无统计学意义（P均>0.05）。X线片定位组与超声定位组手术时长分别为（57.79±6.39）min和（49.84±4.34）min，差异有统计学意义（P<0.01）。X线片定位组和超声定位组导管尖端位置理想率分别为92.4%（97/105）和96.8%（92/95），差异无统计学意义（P=0.167）。两组患儿术后伤口感染、导管相关性血栓形成、导管周围纤维蛋白鞘形成、导管异位、导管相关血流感染、非计划取出输液港的发生率差异均无统计学意义（P均>0.05）。结论 在儿童输液港植入术中经胸心脏超声能直观、实时、准确地监测输液港导管尖端位置，且具有无X线辐射、手术时间短、设备要求简单、手术开展方便等优势，值得在临床推广应用。 |
| 关键词: 完全植入式静脉输液港 上腔静脉 超声心动描记术 导管尖端位置 儿童 |
| DOI：10.16781/j.0258-879x.2021.06.0698 |
| 投稿时间：2020-08-06修订日期：2020-12-18 |
| 基金项目: |
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| Application of transthoracic echocardiography assisted catheter tip position during totally implantable venous access port implantation in children |
| LIU Xin1,TIAN Sha2*,DUAN Xu-fei1,YAN Xue-qiang1,LI Wei2,ZHU Zhen-chuang1 |
(1. Department of General Surgery, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430014, Hubei, China;
2. Department of Ultrasound, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430014, Hubei, China
*Corresponding author) |
| Abstract: |
| Objective To investigate the effect of transthoracic echocardiography on locating the catheter tip during totally implantable venous access port (abbreviated as port) implantation in children. Methods The clinical data of 200 patients with malignant tumor who received port implantation in our hospital from Mar. 2015 to Jun. 2020 were retrospectively analyzed. The patients were divided into X-ray positioning group (105 cases) and ultrasound positioning group (95 cases) according to the catheter tip positioning mode. The general information, operation duration, the rate of ideal catheter tip position and postoperative complications of the 2 groups were analyzed. Results There were no significant differences in age, gender, height, weight, body mass index or tumor types between the 2 groups (all P>0.05). The mean operation duration of the X-ray positioning group and ultrasound positioning group was (57.79±6.39) min and (49. 84±4.34) min, with significant differences (P<0.01). The rates of ideal catheter tip position in the X-ray positioning group and ultrasound positioning group were 92.4% (97/105) and 96.8% (92/95), with no significant difference (P=0.167). There were no significant differences in postoperative wound infection rate, catheter-related thrombosis, fibrin sheath formation around catheter, ectopic catheter, catheter-related bloodstream infection or unplanned port removing (all P>0.05). Conclusion Transthoracic echocardiography can directly and accurately monitor the catheter tip position in real-time during venous access port implantation in children, and has the advantages of X-ray irradiation free, short operation duration, simple equipment requirements and convenient operation, making it worthy of clinical application. |
| Key words: totally implantable venous access port superior vena cava echocardiography catheter tip position children |
