摘要
目的分析数字减影血管造影(DSA)在植入式静脉输液港(CVPAS)体内导管纤维蛋白鞘形成中的应用价值。方法选取2008年12月—2014年4月河北医科大学第四医院CVPAS导管功能障碍患者131例为研究对象。DSA下经静脉港蝶翼针外接口,手推造影剂行DSA,分析DSA表现。结果 CVPAS体内导管纤维蛋白鞘形成51例(38.9%),其中CVPAS体内导管末端局部纤维蛋白鞘形成43例(84.3%,43/51),CVPAS体内导管弥漫性纤维蛋白鞘形成5例(9.8%,5/51),CVPAS体内导管广泛性纤维蛋白鞘形成3例(5.9%,3/51)。DSA可见沿体内导管外壁走形的线样、柱状或不规则状高密度影包裹体内导管,被包裹的导管管径明显增粗,造影剂可向上反流进入腔静脉、CVPAS植入侧皮下软组织或输液座周围皮下软组织内。结论纤维蛋白鞘形成是造成CVPAS导管功能障碍的主要原因之一,DSA可有效评估CVPAS体内导管纤维蛋白鞘形成,具有临床推广价值。
Objective To analyze the application value of digital subtraction angiography （DSA） in fibrin sheath formation in the catheter of central verlous port access system （CVPAS） . Methods 131 patients with catheter dysfunction of CVPAS from the Forth Hospital of Hebei Medical University from December 2008 to April 2014 were enrolled in the study. Through the outer joint of butterfly needles of central verlous port access system, contrast agent was injected by hand to undertake DSA, and the manifestations of DSA were analyzed. Results Fibrin sheath formation was found in 51 （38.9%） patients, among which 43 （84. 3% , 43/51 ） patients had local fibrin sheath formation in the end part of the catheter of CVPAS, 5 （9.8%, 5/51） patients had diffuse fibrin sheath formation in the catheter of CAPAS, and 3 （5.9%, 3/51 ） patients had extensive fibrin sheath formation in the catheter of CAPAS. DSA imaging showed the linear, columnar and irregular high density shadows along the outer wall of the catheter and wrapping the catheter. ＂l^he diameter of the wrapped catheter became thicker. The contrast agent showed reflux into the vena eava and the soft tissues of the skin beside CVPAS implantation or the subcutaneous soft tissues around infusion holder. Conclusion The main cause of catheter dysfunction is fibrin shell formation. Fibrin shell formation of CVPAS can be evaluated accurately by means of DSA which has clinical value for wide application.
出处
《中国全科医学》
CAS
CSCD
北大核心
2016年第3期356-358,363,共4页
Chinese General Practice
基金
2014年度河北省医学科学研究重点课题计划(ZL20140250)
河北省教育厅高校强势特色学科(群)资助项目[冀教高2005(52)]
