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目的:探讨完全植入式静脉输液港(totally implantable venous access ports,TIAP)在乳腺癌术后化疗患者中应用的安全性。方法:采用前瞻性随机对照临床研究方法,选择2015年7月至2016年12月通过病理检查明确诊断为乳腺癌、需通过深静脉置管进行化疗的女性患者240例。将患者随机分为植入式静脉输液港组(TIAP组)和外周静脉穿刺中心静脉置管组(PICC组),每组120例。记录两组一次穿刺成功例数、总穿刺次数,操作失败例数;统计两组患者置管维护费用、导管保留时长;比较两组穿刺近期并发症和远期并发症发生率。结果:直视手术下放置TIAP的一次性穿刺成功率明显高于PICC组(P<0.05),总穿刺次数、置管失败率远低于PICC组(P<0.05)。与PICC组比较TIAP组置管维护费用较高(P<0.05),但导管保留时间明显延长(P<0.05)。结论:通过专业技术及护理团队的规范化操作,TIAP在乳腺癌术后化疗患者中应用的总体并发症发生率低,可作为乳腺癌患者的首选。
Objective: To investigate the safety of totally implantable venous access ports (TIAP) in patients undergoing postoperative chemotherapy for breast cancer. METHODS: A prospective, randomized, controlled clinical study was conducted in 240 women with pathologically confirmed breast cancer who underwent chemotherapy through deep vein catheters between July 2015 and December 2016. The patients were randomly divided into implantable intravenous infusion port group (TIAP group) and peripheral venous catheterization central venous catheterization group (PICC group), 120 cases in each group. The number of successful punctures, the total number of punctures and the number of failed operations were recorded. The cost of catheterization and catheter retention were recorded. The incidences of short-term complications and long-term complications were compared between the two groups. Results: The success rate of one-time puncture with TIAP placed under direct vision operation was significantly higher than that of PICC group (P <0.05). The total number of punctures and catheter failure rate were much lower than that of PICC group (P <0.05). Compared with PICC group TIAP group catheter maintenance costs higher (P <0.05), but the catheter retention time was significantly longer (P <0.05). Conclusion: Through the standardized operation of professional technical and nursing teams, TIAP has a low overall complication rate in postoperative chemotherapy of breast cancer patients and may be the first choice for breast cancer patients.