Complication Rates after Radiological Versus Surgical Placement of Central Venous Catheters
KL Siu, FNY Sin, WP Chu, AXN Lo, KFJ Ma
Hong Kong J Radiol 2012;15:96-100
Objective: To retrospectively compare the complication rates of radiologically and surgically placed central venous catheters in a single tertiary centre over a four-year period.
Methods:All long-term central venous catheters placed over a two-year period by radiological and surgical methods were retrospectively reviewed. For each group of patients, the placement problems, short- and long-term complications, sepsis rates, and catheter lifespan were assessed.
Results:A total of 199 central venous catheters were inserted in 170 patients; 108 catheters were inserted radiologically in 91 patients and 91 catheters were inserted surgically in 79 patients. The indication was chemotherapy in all radiological cases and in 73% of surgical cases. Only one patient had an early complication associated with catheter malpositioning in the surgical group but there was no such complication in the radiological group. The overall rate of infection per 1000 catheter days showed no significant difference between the groups, with the rates being 2.24 in the radiological group and 2.75 in the surgical group. The mean catheter lifespans in the two groups were 246 and 234 days, respectively.
Conclusion: Overall early and late complication rates were low and were similar after both radiologically and surgically placed central venous catheters. We postulate that central catheter insertion is safe in patients requiring long-term vascular access.
中文摘要
比較放射及手術中央靜脈置管術的併發症發生率的研究
蕭廣樂、單雅怡、朱惠邦、羅煦寧、馬家輝
目的：回顧性比較在一所轉介中心兩年內進行放射及手術中央靜脈置管術的併發率。
方法：回顧研究期內所有利用放射及手術的方法長期放置的中心靜脈導管。評估兩組病人置管遇到 的問題、長期及短期併發症、敗血病率和導管使用壽命。
結果：研究期間170名病人放置了199根中心靜脈導管，其中91名病人利用放射學方法放置了108根中 心靜脈導管，另79名病人利用手術方法放置了91根中心靜脈導管。所有利用放射學方法置管及73% 利用手術方法置管的原因皆為化療。利用手術方法置管的組別中只有一宗錯誤置位的早期併發症，而利用放射學方法置管的則無併發。兩組的感染率無顯著分別：放射組為每日每1000根導管發生 2.24次，手術組為每日每1000根導管發生2.75次。導管平均壽命為放射組246天，手術組234天。
結論：放射組和手術組的早期及晚期併發率類似，均屬於低水平。我們認為中央靜脈置管術對於長 期需要血管通路的病人來說是一個安全的方法。