Analysis and treatment of complications in peripheral totally implantable venous access port / 中国实用外科杂志

ABSTRACT

OBJECTIVE: To explore the clinical application of the peripheral totally implantable venous access port(TIVAP) in breast cancer chemotherapy patients,and to understand the clinical applicability and safety of peripheral TIVAP.METHODS: The clinical data of 201 cases using peripheral TIVAP of multi-course chemotherapy in the First Affiliated Hospital of Chongqing Medical University from March 2017 to June 2018 were analyzed retrospectively.The difference of composition ratio of various complications,and difference between the conventional pressure bandaging method and the modified pressure bandaging method for incision hemorrhage,the conventional implantation method and the improved implantation method for catheter ectopic and the difference of the catheter ectopic after left/right peripheral vein TIVAP placement were compared.RESULTS: There were 50 cases(24.9%) of postoperative complications,15 cases(7.5%) of incision hemorrhage,4 cases(2.0%)of catheter-related thrombosis,3 cases(1.5%) of base exposure,4 cases(2.0%) of sack infection,15 cases(7.5%)of primary catheter ectopic,7 cases(3.5%) with no blood withdrawal,2 cases(1.0%) with catheter-related upper limb movement limitation.Using the goodness of fit test(equal ratio) to compare the composition ratio of various complications,χ~2=30.520,P<0.001,the proportion of complications was not obeyed,and the proportion of incision hemorrhage and catheter ectopic was the highest.The conventional pressure bandaging method(78 cases) and the modified pressure bandaging method(123 cases) showed incision bleeding,and the difference was statistically significant [11 cases(14.1%) vs.4 cases(3.3%),χ~2=6.642,P=0.010];the conventional implantation method(90 cases) and the modified implantation method(121 cases) were compared with catheter ectopic,and the difference was statistically significant [9 cases(10.0%) vs.3 cases(2.4%) χ~2=4.131,P=0.042];there was no statistically significant difference in catheter ectopic position after left(106 cases)/right(95 cases) peripheral TIVAP implantation [8 cases(7.5%) vs.7 cases(7.3%),χ~2=0.020,P=0.962].CONCLUSION: The complication of peripheral TIVAP can be effectively controlled through safe management,close observation and active treatment.TIVAP is still a safe and effective intravenous infusion channel for long-term clinical use if there is no contraindication.