| Objectives:Central venous indwelling catheter is widely applied in malignant tumor patients is an important part in the process of treatment,it can provide good venous infusion pathways,avoid repeated puncture veins of pain,but also can ensure the chemotherapy drugs and blood products,antibiotics,parenteral nutrient solution such as input and the pursuance of laboratory tests,and other functions.Deep vein thrombosis(VDT)is easy to occur in patients with malignant tumors due to hypercoagulant state of blood and chemotherapy drugs.In recent years the central venous catheter related blood clots(catheterrelatedthrombosis,CRT)highly attention increasingly.This study in our hospital between January 2020 and December 2020 on preoperative neoadjuvant chemotherapy(NACT Neoadjuvantchemotherapy)in patients with colorectal cancer,the preliminary observation of implantable venous infusion port(Implantablevenousaccessport,Port)to provide evidence for the prevention and treatment of central venous thrombus associated with neoadjuvant chemotherapy before operation.Methods:Third choice of kunming medical university affiliated hospital in colorectal surgery,between January 2020 and December 2020,the pathological diagnosis of colorectal cancer,and according to the TNM staging of preoperative neoadjuvant chemotherapy,under ultrasound guidance and CT positioning via right internal jugular vein implanted venous infusion port and buried in the right side of the chest wall,included in the standard of 98 cases of patients with rectal cancer were retrospectively investigation,According to the end of neoadjuvant chemotherapy and preoperative chest CT examination results,univariate and multivariate logistic regression statistical methods were used to preliminarily observe and screen the incidence and risk factors of extravascular thrombus associated with intravenous infusion port.Results:The incidence of extravascular thrombus associated with preoperative neoadjuvant chemotherapy in 98 patients with rectal cancer was 14.3%(14/98).2 patients with similar symptoms of infection,and 4 patients with similar symptoms did not have thrombosis;In 14 patients with extraductal related thrombosis,the locations of thrombosis were internal jugular vein(11 cases,78.57%)and superior vena cava(3 cases,21.43%),respectively.No thrombosis was observed in atrium or atrial wall.There were significant differences in age,diameter of superior vena cava,indwelling time of infusion catheter and history of catheter blockage(P<0.05).There were no significant differences in gender,hemoglobin,platelet,bodymassindex(BMI),TNM tumor stage,central venipuncture catheter history,times of chemotherapy,chemotherapy regimen,and catheter displacement(P>0.05).The results of multivariate logistic regression analysis showed that the risk factors for extraductal thrombus included age(OR1.119),diameter of superior vena cava(OR0.001),infusion catheter retention time(OR2.088),infusion catheter blockage history(OR10.831),etc.Conclusions:Preliminary clinical observation on extravascular associated thrombosis in patients with neoadjuvant chemotherapy for single-center rectal cancer in intravenous infusion port showed that:1.Extra catheter thrombosis mainly occurred in the internal jugular vein and superior vena cava,with an incidence of 14.3%,and mostly asymptomatic thrombosis.2.Older age,smaller diameter of superior vena cava,longer duration of infusion catheter retention,and history of infusion catheter blockage are the risk factors for extravascular thrombotic formation in patients with neoadjuvant chemotherapy for rectal cancer.3.There were no obvious clinical symptoms associated with thrombus in the patients with extraductal thrombus.Patients with risk factors should be highly alert to the occurrence of extraductal thrombus associated with central vein. |
PDF Full Text Request