摘要
随着超声导引、Seldinger穿刺技术及腔内心电定位技术等在经外周静脉置入中心静脉导管中的广泛应用,近年来经上臂完全植入式静脉给药装置(TIVAD)技术因完全避免血胸和气胸风险及颈、胸部无瘢痕等优势,被越来越多医护人员及患者所接受。目前国内从事此项工作的医护人员涉及内科、外科、麻醉科、介入科等,植入技术、并发症处理及TIVAD使用、维护水平参差不齐,缺乏植入技术质控标准和并发症处理规范。为提高上臂TIVAD植入成功率,降低并发症发生率,保障患者安全,特制定此专家共识。共识就技术适应证和禁忌证、操作流程、技术要点及并发症处理、使用维护等方面进行详细阐述,以期为临床医护人员提供参考。
With the wide application of ultrasound guidance,Seldinger puncture technique,and intracardiac electrical positioning technology in the placement of peripherally inserted central catheter(PICC)in recent years,the placement technology of the totally implantable venous access device(TIVAD)via the upper arm approach has been accepted by more and more medical staff and patients because it has the advantages of completely avoiding the risk of hemothorax,pneumothorax,and not causing neck and chest scar formation.At present,the medical staff engaged in this work in China involve internal medicine,surgery,anesthesiology,interventional departments,etc.In terms of implantation technology,the treatment of complications,the use of TIVAD,the maintenance level,etc.the practical standards are uneven between different medical units,moreover,there are neither the quality control standards of implantation technology nor the handling specifications of complications so far.In order to improve the success rate of TIVAD implantation via the upper arm approach,reduce the complication rate,and ensure the patient safety,this expert consensus is thus proposed.This consensus elaborates on the technical indications and contraindications,the operation process,the technical points,the treatment of complications,and the use and maintenance about the placement technology of TIVAD,so as to provide a practical reference for clinical medical staff.
作者
上海市医学会肿瘤内科专科分会
长三角肿瘤专科联盟
仇晓霞
张学彬
许立超
金光鑫
Oncology Chapter of Shanghai Medical Association;League of Oncology of Yangte River Delta Region;QIU Xiaoxia;ZHANG Xuebin;XU Lichao(不详;Affiliated Renji Hospital of Shanghai Jiao Tong University School of Medicine;Affiliated Cancer Hospital of Fudan University)
出处
《介入放射学杂志》
CSCD
北大核心
2023年第1期2-8,共7页
Journal of Interventional Radiology
关键词
完全植入式静脉给药装置
上臂
中心静脉导管
并发症
维护
totally implantable venous access device
upper arm
central venous catheter
complication
maintenance
