腹腔化疗港在胃癌腹膜转移中应用的安全性分析

薛侃; 李子禹; 闫国军; 高超; 李双喜; 任晖; 季加孚

doi:10.3969/j.issn.1000-8179.2019.01.901

腹腔化疗港在胃癌腹膜转移中应用的安全性分析

Safety analysis of implanted peritoneal ports in gastric cancer with peritoneal metastasis

摘要

摘要:
目的腹腔化疗可将药物直接作用于腹膜转移病灶，正逐渐被应用于胃癌腹膜转移的治疗。通过腹腔化疗港可反复多次进行腹腔化疗，而化疗港的顺利使用是腹腔化疗持续进行的关键。本研究将探讨在胃癌腹膜转移患者留置腹腔化疗港的安全性。
方法回顾性分析2015年6月至2018年6月于北京大学肿瘤医院行腹腔化疗港留置术患者的临床资料，分析腹腔化疗港在胃癌腹膜转移中应用的过程、注意事项及安全性，探讨并发症发生原因及预防处理方式。
结果共有54例患者植入55个化疗港，平均使用时间为8.4(0.8~32.0)个月，共13例出现并发症(23.6%)，发生率从高到低依次为堵塞(7.3%)、严重疼痛(5.5%)、感染(3.6%)、反流(3.6%)、置针困难(1.8%)及皮下硬结(1.8%)。并发症发生的中位时间为化疗港放置后2.1个月。分析未发现与并发症相关的高危因素(P > 0.05)。
结论通过规范与细致的操作，腹腔化疗港在胃癌腹膜转移中的应用安全可行。

Abstract:
Objective Intraperitoneal chemotherapy is increasingly being used in the treatment of gastric cancer with peritoneal metastasis, because the drug can directly act on the metastatic nodules. Repeated treatment can be administered through implanted ports, provided the ports are appropriately managed. Our study aimed to investigate the safety of peritoneal port implantation in patients with gastric cancer with peritoneal metastasis.
Methods We retrospectively reviewed the records of patients undergoing intraperitoneal port implantation for the administration of chemotherapy between June 2015 and June 2018 to investigate the causes of complications and to discuss their management and prevention.
Results Fifty-five ports were implanted in 54 patients with median usage time of 8.4 (0.8-32.0) months. Complications occurred at 13 port sites (23.6%), including obstruction (7.3%), severe pain (5.5%), infection (3.6%), reflux (3.6%), access difficulty (1.8%), and subcutaneous mass formation (1.8%). The median interval from the time of port implantation to the development of complications was 2.1 months. No factor contributing to the complications was identified (P> 0.05).
Conclusions Peritoneal port implantation to systematic chemotherapy in patients with gastric cancer with peritoneal metastasis is safe and feasible if the ports can be carefully managed.

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