DSA引导下经颈内或锁骨下静脉穿刺植入静脉输液港的对比分析

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[Abstract]Objective：ToexploretheeficacyandsafetyofdiferentpunctureapproachesunderDSAguidancefortotaly implantableaccessport（TIAP），andtoprovideareferencefortheselectionofclinicalTIAPapproaches.Methods：Atotalof 267patientswithDSA-guidedTIAPwereselectedanddividedintotheinternal jugularveingroup（116cases）andthe subclavianveingroup（151cases）according tothediffrent punctureapproaches.Thesuccessrateofone-time tube placement，retentiontimeandcomplicationswerecomparedbetween thetwogroups.Results：Thesuccessrateofone-time tube placement under DSA guidance was 99.14%（115/116）in the internal jugular vein group and 98.68 % （149/151）in the subclavian vein group，with no statistically significant difference（ P>0.05 ）.The retention time in theinternal jugularvein group was longer than that in the subclavian vein group（ P<0.05 ）.Comparison after 6-30 months of follow-up，the incidence ratesof peumothorax，periporthaematomaandcatheterectasiaintheinternaljugularveingroupwerestatisticallsignificant lower than those in the subclavian vein group（all P <0.05）.There were no significantthe differencesin thrombus，fibrin sheath or port reversal between the two groups（all P>0.05 ）. Conclusions： DSA-guided transjugular vein approach is a safe， minimallyinvasiveandefectivewayofinfusionportimplantationwithlongercatheterretentiontimeandfewercomplications， which can be the first choice for clinical application.

[Kev wordel Internal iuonlar vein·Suhrlavian vein·Infusion nort·Anoinoranhv dioital snhtraction

完全植人式输液港（totallyimplantableaccessport，TIAP）已在临床中广泛开展，因其导管末端在中心静脉中，可避免高渗、高浓度刺激性药物对外周静脉的刺激和损伤，以及反复穿刺血管引起的血管炎；与传统经外周静脉穿刺中心静脉置管相比，TIAP感染率低、冲换管次数少[1-2]。（剩余6418字）