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目的探讨数字减影血管造影(DSA)与超声实时引导下对乳腺癌患者植入静脉输液港的有效性和安全性。方法选取2013年7月至2015年7月间桂林市妇女儿童医院收治的79例乳腺癌患者,采用随机数表法分为两组,一组40例患者实施DSA引导下植入输液港(DSA组);另一组39例患者实施超声实时引导下植入输液港(超声组)。分别统计两组患者的一次置管成功率和置管相关并发症的发生率。结果 DSA组一次置管成功率为75.0%,低于超声组的100.0%,差异有统计学意义(P<0.01)。置管相关并发症中,DSA组12.5%的患者误伤动脉导致血肿,超声组无,差异有统计学意义(P<0.05)。DSA组患者对导管末端位置均满意,超声组患者中有3例导管末端位置不理想。结论与DSA引导下植入输液港比较,超声实时引导下植入穿刺成功率高,并发症出现率低,但DSA引导的导管末端放置准确性高。
Objective To investigate the effectiveness and safety of digital subtraction angiography (DSA) and real-time guided ultrasound in the implantation of venous transfusion ports in patients with breast cancer. Methods A total of 79 breast cancer patients from July 2013 to July 2015 in Guilin Women and Children’s Hospital were divided into two groups according to the random number table. One group of 40 patients underwent DSA-guided implantation of DSA Group). Another group of 39 patients underwent transrectal real-time guided implantation of transfusion port (ultrasound group). The incidences of primary catheterization and catheter-related complications in both groups were calculated respectively. Results The success rate of primary catheterization in DSA group was 75.0%, which was lower than 100.0% in ultrasound group, the difference was statistically significant (P <0.01). Among the complications related to catheterization, 12.5% of DSA patients had arteries injuring the arteries causing hematoma. There was no difference in ultrasound group (P <0.05). Patients in the DSA group were satisfied with the catheter end position, and 3 cases in the ultrasound group had unsatisfactory catheter end position. Conclusion Compared with DSA-guided implantation into the port, the success rate of ultrasound-guided implantation is high, and the complication rate is low. However, DSA-guided catheter placement accuracy is high.