完全植入式静脉输液港三种不同植入方法的首次成功率比较

目的比较完全植入式静脉输液港不同植入方法的首次成功率。方法2002年4月至2012年5月在我院外科连续植入351例静脉输液港，其中头静脉切开植入234例，锁骨下静脉穿刺植入41例，B超引导颈内静脉植入76例，对不同植入方法的首次手术成功率进行比较。结果头静脉切开植入静脉输液港首次成功率为78.6%（184/234），锁骨下静脉穿刺植入首次成功率为90.2%（37/41），B超引导经颈内静脉植入首次成功率为100%（76/76），头静脉切开组与锁骨下静脉穿刺组比较，差异无统计学意义（χ2=2.981，P=0.059），B超引导颈内静脉穿刺组首次植入成功率高于头静脉切开组（χ2=19.362，P=0.000）和锁骨下静脉穿刺组（χ2=7.677，P=0.014）。头静脉切开组手术并发症发生率为2.2%(4/234)，导管植入颈内静脉2例（1.1%），术后伤口积液2例（1.1%），另两组均未发生手术并发症。结论完全植入式静脉输液港不同植入方法手术并发症发生率均较低，首选B超引导颈内静脉穿刺植入法。

Comparison of the first-attempt success rate among three implantation approaches of the totally implantable venous access ports

ObjectiveTo compare the first-attempt success rate among three implantation approaches of the totally implantable venous access ports (TIVAPs). MethodsTotally 351 patients underwent the TIVAP placement in our hospital between April 2002 and May 2012. Venous access was obtained by cutdown in 234 cases, by the Seldinger technique in 41, and by ultrasound-guided Seldinger technique in 76. The first-attempt success rate was calculated and compared among these three groups. ResultsThe first-attempt success rate was 78.6% (184/234) in the cutdown group, 90.2% (37/41) in the Seldinger technique group, and 100% (76/76) in the ultrasound-guided Seldinger technique group. Obviously, the success rate in ultrasound guided group was significantly higher than the cutdown group (P=0.000) and the Seldinger group (P=0.014). The incidences of surgical complications were low in all these three groups (2.2%, 0, and 0, respectively). ConclusionTIVAPs represent a safe and feasible technique. The preferred placement method is ultrasound-guided Seldinger technique.