Comparative Analysis Of Two Methods Of Implantable Venous Access Port Through Internal Jugular And Subclavian For Cancer Patients Undergoing Radiotherapy And Chemotherapy

Objects:Retrospective analysis of the short-term and long-term effects of implantable intravenous infusion ports through the transjugular vein and tranclavian vein approach,and multi-factor analysis of common complications,in order to provide more evidence and references for reasonable and safe use of intravenous infusion ports.Methods:A total of 1,711 tumor patients who were implanted in the intravenous infusion port in the our hospital from January 2018 to June 2018 were selected as the research subjects.According to different approaches,it is divided into the subclavian vein approach group(n=1414),and the internal jugular vein approach group(n=297),and the two groups were followed up for 12 months.Record the puncture success rate,operation time,catheter retention time,intraoperative and postoperative complications,and quality of life of the two groups;record and calculate the general status of the two groups of patients(gender,age,tumor type,body mass index,previous history of deep vein or PICC puncture),Physical fitness(ECOG)score,etc.Statistical analysis of the above-mentioned related data and single-factor and multi-factor Logistic analysis were performed to compare the overall clinical effect and potential influencing factors of ports through two different approaches.RESULTS:(1)The success rate of one-time puncture is 98.44%in 1414 patients with subclavian vein approach;The success rate of one-time puncture is 100%in 297 patients with internal jugular vein approach.There was no significant difference between the two groups(P>0.05).(2)The average operation time in the subclavian vein group was 12.79±5.65(min),and that in the internal jugular vein group was 19.23±8.62(min).The operation time of subclavian vein group was significantly shorter than that of internal jugular vein group(P<0.05).The average catheter retention time in subclavian vein group(month):11.09 ± 2.13,and in internal jugular vein group(month):11.18±1.98.There was no significant difference between the two groups(P>0.05);(3)Comparison of intraoperative complications and postoperative complications between the two groups:There was no significant difference between the two groups(P>0.05);(4)There was no significant difference between the two groups in the scores of quality of life before and after catheterization(P>0.05);(5)the single factor results showed that there was correlation between the failure rate of the first puncture and the patients’ age,body mass index(BMI)and the previous catheterization history(P<0.05);there was correlation between the incidence of infection in the port of infusion and patients’ age,ECOG score(P<0.05);there was correlation between the incidence of catheter-related thrombus and only with patients’ previous catheter history(P<0.05).(6)the results of multivariate logistic analysis showed that:the efficacy of implantable IV port was correlated with age and body mass index(P<0.05),There was no significant correlation among gender,tumor type,ECOG score and previous catheterization history(P>0.05).Conclusions:(1)Both the subclavian and internal jugular vein implantation of intravenous infusion port have a high success rate of puncture.The intraoperative and postoperative complications and adverse reaction rates are low,shows that both implantation methods are safe and feasible.The operation time of the subclavian vein approach is significantly shorter than that of the internal jugular vein approach,which has certain operational advantages.There was no significant difference in the incidence of intraoperative and postoperative complications and the length of catheter indwelling.(2)there are many factors influencing the therapeutic effect of intravenous infusion port,the success rate of the first puncture was related to the patients’ age,body mass index,and previous catheterization history;the incidence of infection was related to the patients’ age and ECOG score;the incidence of thrombosis was related to the patients’ previous catheterization history.The results of multi-factor logistic analysis showed that the total physical efficacy of the port was only related to the age and body mass index of the patients.