植入式静脉输液港的并发症及护理研究进展

植入式静脉输液港（Venous Port Access，VPA），又称植入式中央静脉导管系统（Central Venous Port Access System，CVPAS），是一种可植入皮下长期留置在体内的静脉输液装置。此技术在国外已有20多年的应用经验，在我国的应用也在不断增加，现将其在临床应用中的常见并发症及其护理综述如下。     

植入式静脉输液港的临床应用及护理

植入式静脉输液港是一种可植入皮下,长期留置在体内的静脉输液装置,为需要长期输液治疗及化疗的病人提供了可靠的静脉通路。能将各种药物直接输送到中心静脉处,避免了高浓度、刺激性强的药物对一般静脉输液造成的外周血管硬化、栓塞及静脉炎,也有效防止了化疗时药物对血管壁的损伤、药物外渗等原因造成的局部组织坏死。我科于2004年10月以来引进了植入式静脉输液港,通过对患者精心护理及健康指导,并做好输液港的维护,确保了各项治疗顺利完成,并提高了患者的生活质量,临床效果满意。1临床资料我科2004年10月～2006年10月为5例肿瘤术后者植入…     

完全植入式静脉输液港输液障碍的原因分析及处理

完全植入式静脉输液港（totally implantable central venous access ports,输液港）是一种完全植入于皮下可供长期留置在体内的静脉输液装置。它主要由一根硅胶或聚氨酯材料的导管系统和供穿刺的钛合金穿刺座组成。国外自1982年起开始使用,现已广泛应用于肿瘤化疗患者的治疗及胃肠外营养等领域。输液港不仅有留置时间长的特点,同时与其他中心静脉导管相比,     

植入式静脉输液港常见问题及护理

[目的]探讨植入式静脉输液港常见问题及护理。[方法]通过观察植入静脉输液港200余次,分析护理方法。[结果]总结临床使用的穿刺时间、穿刺方法,防堵塞、防感染、防扎伤的护理。[结论]通过总结植入式静脉输液港常见问题及护理,有助于广泛开展静脉输液港这一技术,减少反复穿刺给病人带来的痛苦,提高病人的生活质量。     

植入式静脉输液港常见问题及护理

[目的]探讨植入式静脉输液港常见问题及护理.[方法]通过观察植入静脉输液港200余次,分析护理方法.[结果] 总结临床使用的穿刺时间、穿刺方法,防堵塞、防感染、防扎伤的护理.[结论] 通过总结植入式静脉输液港常见问题及护理,有助于广泛开展静脉输液港这一技术,减少反复穿刺给病人带来的痛苦,提高病人的生活质量.     

完全植入式静脉输液港的应用护理及并发症

完全植入式静脉输液港(Totally implantable venous-access ports,TIVAP)是一种可植入皮下长期留置在体内的静脉输液装置,主要由供穿刺的输液座和静脉导管系统组成。因其全部装置均埋藏     

植入式静脉输液港在化疗病人中的应用及护理

[目的]总结63例植入式静脉输液港化疗病人的护理。[方法]选择63例化疗病人，留置植入式静脉输液港。注意穿刺针的穿刺技巧和护理，加强穿刺隔皮肤肿胀等特殊情况的处理。[结果]63例中，仅3例病人出现异常情况而拔管。[结论]化疗病人应用植入式静脉输液港后，应加强无菌操作，严格按操作规程穿刺，出现异常情况时，细心处理。     

植入式静脉输液港的临床应用及护理

[目的]探讨植入式静脉输液港的临床应用,总结有效的护理方法。[方法]对78例女性乳腺癌病人采用植入式静脉输液港,同时加强护理。[结果]78例病人均置管成功,26例通过颈内静脉植入,42例通过锁骨下静脉植入;术后经X线片确定导管末端位置较为理想,无一例病人出现血气胸等并发症。[结论]临床应用植入式静脉输液港可很好地解决病人反复穿刺带来的痛苦,减轻护士的工作量和降低穿刺难度。     

应用植入式静脉输液港患者的护理

植入式静脉输液港是一种可植入皮下、长期留置在体内的静脉输液装置,2003年9月以来为31例患者使用了植入式静脉输液港。为提高患者的自我护理能力,使植入式静脉输液港得到安全、有效的维护,对患者实施心理指导、输液护理、并发症的观察及出院健康教育等措施,取得了满意的效果。     

植入式静脉输液港的临床应用及护理

目的探讨植入式静脉输液港的临床应用与护理。方法对5例植入静脉输液港患者进行研究。结果 5例患者均置管成功,其中锁骨下静脉3例,颈内静脉2例,术后行X线片确定导管末端位置位于上腔静脉,无血气胸等并发症,术后当天输液。结论植入静脉输液港解决了患者频繁输液的痛苦,减轻了护士的工作量,提高了护理安全性,减少了输液并发症。     

Clearing obstructed totally implantable central venous access ports

Totally implantable central venous access ports (IVAPs) are frequently used in oncology to assure chemotherapy delivery and other tasks. Obstruction of IVAPs is rare, but when it does occur it may result in treatment delays and/or invasive surgery for the patient. An IVAP unblocking protocol was implemented by the nursing staff of our department. The protocol is based on a precise decision tree comprising several progressive steps: (1) needle exchange; (2) if no result is observed, placement of a second needle and reservoir flushing with normal saline; and (3) if no result is observed, use of urokinase in the two-needle system. During 1?year, all consecutive patients presenting an obstructed IVAP in our unit benefited from this protocol. Medical files were then retrospectively reviewed to look for complication and for factors associated with blocked IVAPs. A total of 12 patients were included. The rate of successful IVAP unblocking was 92% (n?=?11/12). The only unblocking failure was due to a mechanical obstruction, i.e., a bent catheter. No local or general complications were reported immediately after the unblocking protocol or in the following month. In 83% of the cases, obstruction occurred during use of IVAPs. Mains treatments administered when obstruction occurred were mannitol 20% (25%) and perfusion completed but non-flushed (50%). In the remaining 17%, obstruction was present before any action (at needle insertion). With all due caution because of the retrospective nature of this study, the IVAP unblocking protocol presented here appears to be efficacious and safe, and thus can be recommend for clinical practice.     

8例卵巢癌终末期患者完全植入式静脉输液港的护理

目的探讨卵巢癌终末期患者完全植入式静脉输液港(简称输液港)的护理要点。方法对8例卵巢癌终末期患者放置输液港,并配合做好护理工作。结果 8例卵巢癌终末期患者埋置输液港期间未发生感染、漏液、渗液、堵管及针尖移位等现象。结论卵巢癌终末期患者抵抗力低下,其埋置输液港感染风险大,护理难度高,个体化护理方案并注重维护可以确保卵巢癌终末期患者输液港安全使用。     

Shanghai expert consensus on totally implantable access ports 2019

Totally implantable access ports (TIAPs) are used for patients with poor peripheral vascular support requiring central venous access. In recent years, TIAPs have been gradually accepted and promoted by patients, doctors, and nurses owing to their advantages of convenient carrying, a long maintenance period, low complications, and a high quality of life for patients. Currently, medical personnel that handle TIAP implantation and management in China are from different areas of healthcare, including surgery, internal medicine, radiology, nurse anesthesia, vascular access, etc., and many only handle TIAP as a part of their duties. Therefore, the operating procedures and steps for the diagnosis and treatment of complications of TIAP vary from person to person, resulting in different incidence and treatment methods for complications in the implantation and use of TIAP in different medical units. Based on this, we have updated the Shanghai expert consensus on TIAPs from 2015 and explored the diagnosis and treatment procedures of related complications while continuing to emphasize standardized implantation and maintenance.     

Systematic review: malfunction of totally implantable venous access devices in cancer patients

Purpose  

Malfunction of totally implantable venous access devices is a common complication. The purpose was to identify definitions used to describe malfunction and to investigate the incidence of malfunction in different types of port and catheter designs.     

完全植入式静脉输液港手术方式及并发症研究进展

完全植入式静脉输液港(TIVAD)可以用于输注化疗药物和采集血液标本。在需要长期、间断地进行静脉输注等操作时,TIVAD是一个非常合适的选择,TIVAD的应用使肿瘤患者的生活质量得到了极大改善。TIVAD相关的并发症分为即刻并发症、早期并发症和后期并发症,提高手术、穿刺技术,或在超声或DSA引导下操作可以降低并发症的发生率。     

植入式静脉输液港在鼻咽癌患者治疗中的应用和护理

分析18例鼻咽癌患者使用植入性静脉输液港的效果,并总结其护理经验。18例鼻咽癌患者均一次性成功植入输液港,其中16例患者已顺利完成治疗。18例输液港均顺利保留至今。植入式静脉输液港为鼻咽癌患者治疗期间的化疗、补充液体及营养支持建立了良好的静脉通路,使用和维护简单,患者耐受好,并发症少,生活质量高,减轻了护理工作量。     

植入式静脉输液港的应用及维护进展

对植入式静脉输液港的植入方法、手术配合、使用和维护方法、常见问题及处理等进行综述,旨在为临床护理工作提供借鉴,更好地保证静脉输液港为长期化疗和其他静脉治疗患者提供有效的通路。     

Comparative study of nursing protocols for venous access ports.

The purpose of this study was to compare the incidence of infection in patients having venous access ports (VAP) accessed using commercially prepared kits with patients having VAPs accessed using a nursing protocol developed by RNs in the outpatient chemotherapy unit. The RN-developed protocol allowed venous access devices to be approached without sterile gloves and with minimal equipment, a technique which is more time efficient and cost effective. A convenience sample of 26 outpatients was randomly assigned to two groups. Patients in Group I, accessed using the commercially prepared kits, were accessed a total of 69 times. Patients in Group II, accessed using the nursing protocol, were accessed a total of 102 times. The two groups were compared for occurrence of infection as identified by elevated white blood count (WBC); febrile episode (greater than 100.4 degrees F); or drainage, pain, redness, swelling, or warmth at the port site. Data collected over a period of 6 months indicated no documented infection in either group. Results from this study will be used to support changes in nursing practice.