Clinical Application And Study Of Ultrasound-guided Insertion Of Implantable Venous Access Port Though Internal Jugular Vein

Objective: Study the complications, improved ways and clinicalsignificance of ultrasound-guided internal jugular vein implantation ofaccess port. Understand the safety and feasibility of the access port byobserving the development of the central venous catheter，contrastingdifferent ways of infusion port implanted.Methods：We choose the breast cancer patients which need for theadjuvant chemotherapy. Implantation of access port can be operationunder local anesthesia or general anesthesia after modified radicalmastectomy of breast cancer finished. General we choose the rightinternal jugular vein for puncturing. And we select the best puncture sitebefore or in surgery. The puncture site of low internal jugular veinpuncture is always selected in about2~3cm above the rightsupraclavicular. After punctured, the catheter tip of access port has beenput on the superior vena cava through the subcutaneous. At the same time,we connect the other end of the catheter with the injection seat of accessport, buried in the ipsilateral subclavian fossa.Results：Since September2011to March2013, we selected240cases of breast cancer passing through the internal jugular veinimplantable access port, age36to62years old; there were238patientswith right internal jugular vein puncture and access port implantation,2patients with left internal carotid vein access port implantation. Therewere83cases according to the experience of blind puncture, and157cases were punctured under ultrasound guidance. Complications occurred in3cases (3/240), transfusion difficulty in1patients, pouch infection in1patients, catheter drift in1patients. As of March20,2013, the port wereremoved in176cases, among them,175cases of patients took out thedownlink access port in local anesthesia after undergoing adjuvantchemotherapy. And only1patient suffered from postoperativecomplications and removed. The average use time of the access port was150d (14~168d).Conclusion: Ultrasound-guided internal jugular vein implantation ofimplantable access port, is a safe and effective，and reducing the pain ofpatients in the infusion method.