Upper-extremity deep vein thrombosis related to central venous port systems implanted in cancer patients.
Upper-extremity deep vein thrombosis related to central venous port systems implanted in cancer patients.
复制标题
与癌症患者植入中心静脉港系统相关的上肢深静脉血栓形成。
DOI：
10.1259/bjr/41019720
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发表时间：
2010
期刊：
影响因子：
--
通讯作者：
M. Suenaga
中科院分区：
文献类型：
--
作者：
S. Yukisawa;Y. Fujiwara;Y. Yamamoto;T. Ueno;K. Matsueda;A. Kohno;M. Suenaga
本研究的目的是评估癌症患者与植入中央静脉港（CV-port）系统相关的上肢深静脉血栓（UEDVT）的发生率和病程。从2007年7月到2008年7月，连续92名因结直肠癌化疗而接受CV端口植入的患者被前瞻性地纳入该研究。所有患者均按规定时间间隔接受超声检查（US），以评估导管相关静脉血栓形成的发生率。我们将超声诊断分为三类：0型，无血栓； I型，导管周围有血栓，但不阻碍静脉血流； II型：血栓伴静脉血流阻塞。初步超声检查后，25 例 (27%) 被归类为 0 型，64 例 (70%) 被归类为 I 型，III 例 (3%) 被归类为 II 型。 64例I型病例中，4例在一个月内恶化为II型，另外3例（包括1例发生肺栓塞）1个月后转为II型。在其他 I 型病例中，12 例改善为 0 型，45 例仍为 I 型。所有 10 例 II 型患者均接受抗凝治疗并恢复化疗，血栓形成未恶化。在接受长期化疗的癌症患者中，导管相关的 UEDVT 患病率出乎意料地高，可以在植入 CV 端口后的早期通过超声检测到。鉴于患有 UEDVT 的癌症患者可能比没有 UEDVT 的癌症患者预后更差，临床医生应考虑仔细监测 UEDVT 并引入抗凝治疗。
The purpose of the current study was to evaluate the incidence and course of upper-extremity deep vein thrombosis (UEDVT) related to an implanted central venous port (CV-port) system in cancer patients. From July 2007 to July 2008, 92 consecutive patients who underwent implantation of a CV-port for chemotherapy for colorectal cancer were prospectively enrolled in the study. All patients were examined at prescribed intervals by ultrasonography (US) to estimate the incidence of catheter-related venous thrombosis. We categorised ultrasound diagnosis into three types: Type 0, no thrombus; Type I, thrombi around catheter without obstruction of venous flow; Type II: thrombi with obstruction of venous flow. Upon initial ultrasound examination, 25 cases (27%) were categorised as Type 0, 64 (70%) as Type I and III (3%) as Type II. Of the 64 Type-I cases, 4 cases worsened to Type II within a month, and 3 others (including 1 patient who developed pulmonary embolism) became Type II after 1 month. Of the other Type-I cases, 12 cases improved to Type 0 and 45 cases remained Type I. All 10 patients categorised as Type II underwent anticoagulant therapy and resumed their chemotherapy without exacerbations of thrombosis. In cancer patients undergoing long-term chemotherapy, there is an unexpectedly high prevalence of catheter-related UEDVT, which can be detected by ultrasound at an early stage after implantation of a CV-port. Given that cancer patients with UEDVT may have worse outcomes than those without, clinicians should consider careful monitoring for UEDVT and introducing anticoagulant therapy.
影响因子：
39.2
作者：
Prandoni, P;Lensing, AWA;Prins, MH
通讯作者：
Prins, MH