经股浅动脉入路介入法药盒植入术研究

目的：研究经股浅动脉植入介入药盒（PCS）的可行性。方法：（1）患者60例，无栓塞适应证的原发性肝癌36例，转移性肝癌14例，其它晚期肿瘤10例，均经股浅动脉植入PCS，泵导管 端置于相应靶血管50例，10例置于胸或腹主动脉；（2）杂种犬2只，采用Seldinger技术经股动脉置入PCS导管至主动脉，观察指标：（1）临床体征；（2（泵导管远端位置，形态及与体位关系，靶血管及植入侧股动脉形态；（3）PCS植入前，后股动脉血流动力学变化；（4）狗PCS植入侧股动脉病理学改变。结果：导管到位率95％，植入侧下肢及局部无异常。植入侧股动脉无狭窄，无明显血流动力学改变，靶血管闭塞3．3％，PCSN地管移位8．3％，PCS导管远端位于主动脉者无导管下移，移位者其导管远端均不同程度缓慢下移。结论：经股浅动脉化疗泵植入术安全可行，熟练的植入泵技术可避免或减少并发症，主动脉内泵导管远端是滞下坠与体们无关，主要取决于血管，血液生物物理学特性及泵导管远端形态。

A study of feasibility of interventional implantation of the port catheter system(PCS) via femoral artery

Objective:To explore the feasibility of interventionalimplantation of the PCS via femoral artery.Methods:60 cases of liver tumor and others were studied using this technigue.The catheter tip of PCS was placed in the targeted vessels of 50 patients,aorta in 10 cases.Two mongrel canines were implanted the cathter of PCS through femoral artery by seldinger's technique.The following indices were observed:①Clinical symptom;②The location and shape of the catheter tip,the relationship between the catheter and the body's position,the morphology of the target vessel and the femoral artery of access;③The hemodynamics of femoral artery before and after implantation of PCS;④The pathological change of the canine femoral artery being implanted PCS.Results:The rate of success in catheterization was 96.6%.The ipsilateral lower limb and region of implanting PCS had no abnormalities.The femoral artery following implanting PCS had no stenosis and no obvious hemodynamical changes.The complications were following:the occlusion of target vessel in 3.3%, and catheter displacement in 8.3%,which migrated slowly downward at different degrees.The tip of catheter placed in aorta had no migration.Conclusion:The implantation of the port catheter system via femoral artery is safe and feasible, and the skilled manipulation can avoid or reduce complications.The downward migration of catheter in aorta is not associated with the body's position,but mainly depended on the biophysical characteristics of the vessel and blood,and the shape of the catheter tip.