靜脈內植式輸液塞合併症之初探

The Complications of Total Implantable Central Venous Access Port

靜脈內植式輸液塞為癌症病患最常使用之輸液管道，本研究目的為了解植入靜脈內植式輸液塞在植入早期及使用後產生之合併症機率。於北部某醫學中心，監測九十三年一至六月所有靜脈內植式輸液塞植入手術之長期化療癌症病患677位個案，共682人次，作回溯性追蹤其術後一年併發症發生率。早期併發症（3例，發生率.44％）包括2例導管阻塞（發生率.29％），1例皮下組織感染（發生率.15％）。晚期合併症共37位(發生率5.42％)，包括功能喪失(阻塞或栓塞)20位(發生率3.2％)，導管相關性血流感染及局部感染各6位(發生率.88％)，2位導管移位或斷裂（發生率.29％），2位外滲（發生率.29％）及血腫個案1位（發生率.15％）。栓塞為靜脈內植式輸液塞植入個案最常見之合併症，宜進一步針對栓塞形成建立監測與預防栓塞之相關研究，以有效降低合併症機率。

Objective: The aim of this study was to examine the early and late complication rate of totalimplantable central venous access ports(TIAP)for long-term chemotherapy delivering.Patients and Methods: Six hundred and seventy seven patients suffering from a neoplasticdisease, who required long-term chemotherapy and underwent insertion of total implantable centralvenous access ports from January to June 2004, were retrospectively studied for one year afterimplantment in the Taipei Veterans General Hospital.Results: Early complications(n=3, .44%)included blood clot obstruction(n=2, .29%), cutaneoussite infection(n=1, .15%). Late complications(n=37,5 .42%) included malfunction(thrombosis& obstruction, n=20,3 .2%), Port-related infection(n=6, .88%), cutaneous site infection(n=6,.88%), displace or fracture (n=2, .88%), port extrusion(n=2, .88%), and hematoma(n=1, .44%).Infection was caused by Candida(n=2,33 .3%), Acinetobacter spp(n=1,16 .6%), Acinetobacterbaumannii(n=1,16 .6%), Staphylococcus aureus(n=1,16 .6%), and burkholderia cepacia(n=1,16.6%).Conclution: Thrombosis inducing malfunction is main complication of total implantable centralvenous access ports(TIAP). Additional studies are required for monitoring thrombosis formativeand preventing methods to reduce the complication rate