- 期刊
中央靜脈導管系統在惡性腫瘤病人的應用
Central Venous Implantable Access System in Patients with Malignancy
摘要
裝置中央靜脈導管系統，是一個簡單而且併發症很少的手術方法。它是將一個矽質的導管裝植於中央靜脈裡，不但可以應用於癌症病人的化學治療，而且可以用於靜脈營養劑的補充、長期抗生素的給予、血液輸液的補給及血液抽取檢查等各方面，使用的範圍相當廣泛。台中榮總耳鼻喉科自1993年5月至1993年12月止，成功地應用中央靜脈導管系統於75例頭頸部腫瘤的病人、1例白血病、1例惡性淋巴瘤及1例肝癌病人的化學治療及靜脈營養輸液的補充。手術後追蹤2至9個月，其中發生導管系統阻塞者有5例(6.4%)，血液回抽阻塞者，有4例(5.1%)，導管系統移位者有2例(2.6%)，血腫形成者有1側(1.3%)，並沒有病人發生傷口感染、血氣胸或血管栓塞等併發症。中央靜脈導管系統的裝置，不但可以免除找尋病人靜脈的煩惱，減少病人身心的痛苦，而且手術後照顧上十分容易，並不影響病人的日常生活，實在是頭頸部腫瘤病人的一大福音。
並列摘要
Implantable vascular access system is now an integral part of the management of patients with malignancy. It is required for intensive chemotherapy, parenteral nutrition, administration of supportive blood products and antibiotics and obtaining blood specimens for laboratory analysis in addition. The central venous system not only spares the psychological and physical trauma of cancer patients but also provides an easy and convenient daily care after operation. Therefore, the development of this system affords much advantage to cancer patients. From May 1993 to December 1993, We used implantable vascular access system successfully in 75 head and neck cancer patients, 1 leukemia, 1 malignant lymphoma and 1 hepatoma patient. All the head and neck cancer patients were advanced cases with distant metastasis or recurrence after receiving surgery of irradiation previously. Intensive chemotherapy and parenteral nutrition were given through this system in these 78 patients. We encountered device obstruction in 5 patients (6.4%), blood withdrawal occlusion in 4 patients (5.1%), device extrusion in 2 patients (2.6%), and hematoma in 1 patient (1.3%). No wound infection, sepsis, pneumohemothorax, or vessel thrombosis was noted after 2 to 9 months follow-up. The application of implantable vascular access system is a simple and easy method. It has less complication and morbidity. Before the operation, we should be familiar with the surgical anatomy and procedures to prevent operative complication, meanwhile we must give thorough instruction to patients and their families. It is mandatory to teach them how to use and protect the system. From all aspects, the access system is proved to have great benefit in the management of advanced head and neck cancer patients.