摘要
目的探讨完全植入式静脉输液港(TIVAP)术后港体翻转的发生原因、确诊方法、处理措施及预防策略。方法回顾性分析2015年12月至2018年10月428例接受TIVAP植入术患者临床资料。记录术后港体翻转率、发生时间、原因分析和处理措施。结果428例患者术中港体均未缝合固定,术后6例发生港体翻转,均经影像学检查证实,港体翻转率为1.4%(6/428)。其中男2例,女4例;年龄55~71岁,平均(65.0±6.3)岁。术后23~451 d出现港体翻转,2例考虑与皮下组织过剩/疏松相关,1例考虑为囊袋尺寸过大,其余3例原因不明。处理措施:单纯手法复位3例,囊袋内注射0.9%氯化钠溶液后手法复位1例,囊袋内注射0.9%氯化钠溶液手法复位失败后切开复位1例,直接切开复位1例。结论TIVAP植入术后港体翻转发生率低,易于确诊和复位,因此没有必要常规缝合固定港体。建议选择宽基底、凸缘设计港体。港体翻转原因尚需进一步研究探讨。
Objective To discuss the causes,diagnosis,treatment measure and prevention strategy of injection pedestal(also known as port body)inversion after the placement of totally implantable venous access port(TIVAP).Methods The clinical data of a total of 428 patients,who underwent TIVAP placement between December 2015 and October 2018,were retrospectively analyzed.The postoperative occurrence of injection pedestal inversion and the time of its occurrence were recorded,the causes were analyzed,and the treatment measures were evaluated.Results None of the injection pedestal was sutured and fixed in all the 428 patients.Postoperative inversion of the injection pedestal occurred in 6 patients,the diagnosis of inversion was confirmed by imaging examination.The injection pedestal inversion rate was 1.4%(6/428).Of the 6 patients,2 were males and 4 were females,aged 55-71 years with a mean of(65.0±6.3)years.The injection pedestal inversion occurred within 23-451 days after its placement.In 2 patients the cause of injection pedestal inversion may be related to the redundancy and/or loose of the subcutaneous tissue,in one patient it may be related to the large size of capsule,and in the remaining 3 patients the causes of injection pedestal inversion were unknown.The treatment measures used by the authors included simple manual restoration(n=3),intracapsular injection of 0.9%sodium chloride solution followed by manual restoration(n=1),direct restoration with surgical incision after intracapsular injection of 0.9%sodium chloride solution and failure of manual restoration(n=1),and direct restoration with surgical incision(n=1).Conclusion Clinically,the incidence of injection pedestal inversion after TIVAP is very low,and this disorder is easily to be diagnosed and restored.Therefore,it is not necessary to make regular suturing to fix the injection pedestal.In clinical practice it is recommended to select and use the wide base and flange-designed injection pedestal.The causes of injection pedestal inversion need to be further studi
作者
丁伟
周奇
孙飞虎
孙磊
王维涛
徐平
范晨
陆进
王卫东
DING Wei;ZHOU Qi;SUN Feihu;SUN Lei;WANG Weitao;XU Ping;FAN Chen;LU Jin;WANG Weidong(Department of Interventional Radiology,Wuxi People’s Hospital,Wuxi,Jiangsu Province 214023,China)
出处
《介入放射学杂志》
CSCD
北大核心
2020年第3期291-295,共5页
Journal of Interventional Radiology
关键词
完全植入式静脉输液港
港体翻转
发生原因
诊断
治疗
预防
totally implantable venous access port
injection pedestal inversion
cause of occurrence
diagnosis
treatment
prevention
