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Objective To study the advantages and disadvantages of two methods(the peripherally inserted central venous catheter (PICC) and the totally implantable venous-access ports (TIVAP) in the chemotherapy of tumor patients. Methods The clinical data of 160 patients treated with PICC or TIVAP from March 2016 to December 2016 were retrospectively reviewed,and the complications of the two groups were compared and reviewed. Results The catheter occlusion rate,catheter infection rate and the incidence of phlebitis in the TIVAP group were lower than that in the PICC group (P<0.05). Conclusions The patents treated with TIVAP have fewer complications and prolonged indwelling time has no impact on the life quality of patients.
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A lock solution composed of gentamicin sulfate (5 mg/mL) and ethylenediaminetetraacetic acid disodium salt (EDTA-Na2, 30 mg/mL) could fully eradicate in vivo bacterial biofilms in totally implantable venous access ports (TIVAP). In this study, fabrication, conditioning and sterilization processes of antimicrobial lock solution (ALS) were detailed and completed by a stability study. Stability of ALS was conducted for 12 months in vial (25 °C ± 2 °C, 60％ ± 5％ relative humidity (RH), and at 40 °C ± 2 °C, RH 75％ ± 5％) and for 24 h and 72 h in TIVAP (40 °C ± 2 °C, RH 75％ ± 5％). A stability indicating HPLC assay with UV detection for simultaneous quantification of gentamicin sulfate and EDTA-Na2 was developed. ALS was assayed by ion-pairing high performance liquid chromatography (HPLC) needing gentamicin derivatization, EDTA-Na2 metallocomplexation of samples and gradient mobile phase. HPLC methods to separate four gentamicin components and EDTA-Na2 were validated. Efficiency of sterility procedure and conditioning of ALS was confirmed by bacterial endotoxins and sterility tests. Physicochemical stability of ALS was determined by visual inspection, osmolality, pH, and sub-visible particle counting. Results confirmed that the stability of ALS in vials was maintained for 12 months and 24 h and 72 h in TIVAP.
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Objective To investigate the accuracy and safety of using normal saline as a medium to guide the catheter lumen to assist the localization of the catheter tip. Methods This study included the patients with hematological malignancies in our fully implantable venous port. We enrolled 105 patients from January 2014 to December 2015 as control group, and 220 patients from January 2016 to June 2017 as the experimental group. The control group used the traditional fully implantable venous port after the chest X slice to determine the location of the catheter tip. The experimental group used the intracavitary electrocardiogram location technology to assist the complete implantable venous port catheter tip positioning catheter, then chest X film. Results No catheterization occurred in all the patients. The rate of catheter placement was 100％. In the experimental group, 179 patients (81.36％) had the best placement of catheter tip (i.e., superior vena cava right atrium junction, CAJ), and 35 patients (52.38％) in the control group had the best placement of catheter tip. The proportion of the catheter tip located in the best position (the superior vena cava auricular commissure and CAJ) in the experimental group was higher than that in the control group (χ2=29.615, P < 0.05). Conclusions By the injection of saline guided endocardial mapping real-time monitoring of totally implantable venous transfusion port catheter tip position, can guide the surgeon to grasp the real-time operational direction of totally implantable venous transfusion port catheter tip, accurately positioning the catheter tip position, improve the surgical success rate, worthy of clinical use.
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Objective To explore the clinical application and complication management of ultrasound-guided implantation of venous access port via axillary vein in breast cancer patients with chemotherapy.Methods From Sep.2016 to Jan.2017,50 breast cancer patients were implanted implantable venous access ports via the axillary vein under ultrasound guidance in the First Affiliated Hospital of Chongqing Medical University,among whom 25 cases with the left-side breast cancer,the other cases with right-side breast cancer.The effects of the application of implantation method and complication management were observed.Results The success rate of venous access ports via the axillary vein under ultrasound guidance was 98％(49/50).The operation time was (26±4) mins.The number of puncture ≤ 2 times was 96％ (48/50).The incidence of intraoperative complications including pneumothorax (0％,0/50),error arterial puncture rate 4％ (2/50),catheter ectopic incidence 2％(1/50),and intraoperative blood loss 2％(1/50).The long-term postoperative included pinch-off syndrome (POS) (0％,0/50),thromboembolism (2 ％,1/50),infection (2％,1/50) and catheter detachment (0％,0/50).Conclusion Ultrasound-guided implantation of venous access port via axillary vein has features of high success ratio,high safety,and low complication rate,which provides additional venous channel selection of port implantation.
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Objective To investigate and analyze the experience of planting and maintaining implantable venous access ports(IVAP) in management of post-operative breast cancer patients. Methods Breast cancer pa-tients receiving IVAP after surgery from Mar. 2011 to Jun. 2014 were retrospectively analyzed. The relative com-plications were documented and summarized during implanting operation. Results 468 patients received IVAP, among whom 451 patients underwent piercing implantation via right internal jugular vein, 15 patients underwent piercing implantation via right subclavian vein, and 2 patients underwent piercing implantation via left internal jugular vein. The mean cathe tering leng th was 12.8 cm for patients receiving IVAP via right internal jugular vein, ranging from 12 to 15 cm. Thereinto, 30(6.4%) patients experienced shot-term complications including 16 cases of puncture difficulty, 5 cases of accidental arterial puncture, 2 cases of extravasation, 2 cases of blood aspiration dif-ficulty and 5 cases of arrhythmia. Three cases had long-term complications as the following:one case of catheter-re-lated infection, one case of catheter lost, and one case of incision rupture. Conclusions IVAP is a safe and effec-tive intravenous infusion device. It is crucial to choose individualized implanting access and length by professional surgical team.
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Objective To summarize our experiences of applying totally implantable venous access ports ( TIVAP) in chemotherapy for young children with malignant tumors.Methods Between December 2011 and May 2015, 50 young children with malignant tumors were implanted with TIVAP in Anhui Provincial Children's Hospital for chemotherapy.A retrospective review was conducted with their clinical records, focusing on success rate, clinical effect, and complications of TIVAP.Results The technical success rate was 100%with no intrao-perative complication such as puncture-related injury.In one case the device had to be adjusted through reopera-tion due to malposition of catheter tip.The port was removed in one case after 1 year due to infection.15 patients had the ports removed after the completion of chemotherapy.5 patients died due to the relapse and metastasis of tumor.29 patients are still using the port with no complications.Conclusion TIVAP is a safe device in young children, ensuring reliable vascular access for chemotherapy and improving patients'quality of life.
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ObjectiveTo investigate the nursing key points to 8 end-stage ovarian cancer patients with totally implantable venous access ports.Method The totally implantable venous access ports were used in the 8 patients and nursing was carried out to them.Result There were no occurrences of infection,leakage,seepage,pipe obstruction and the needlepoint shift.Conclusions The ovarian cancer patients in the end-stage had very low resistance and high risk of infection.Individualized nursing care to them may ensure the use of the ports in a safe way.
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Objective:Venous indwelling needle has been widely used in clinical treatment as a replacement of scalp acupuncture, and keeps constantly upgrading. Emergency use and nutrient supply by intravenous infusion through venous indwelling needle. The article discusses venous indwelling needle in clinical treatment for dermatological patients. Methods:It compares different complications through two different puncture and sealing methods of venous indwelling needle. Results:It summarizes highly possible complications during and after operating venous indwelling needle, and it proves that the latest puncture and sealing methods of venous indwelling needle could be better for those patients with skin damage, according to the different states of their skin and vein. Conclusion:For dermatological patients, their skin and vein could be protected effectively through the latest clinical methods of venous indwelling needle. The occurrence of many complications and patients’ pain could also be reduced.
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Objective To compare the first-attempt success rate among three implantation approaches of the totally implantable venous access ports (TIVAPs).Methods Totally 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.Results The 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).Conclusion TIVAPs represent a safe and feasible technique.The preferred placement method is ultrasound-guided Seldinger technique.