肿瘤患者上臂植入式静脉给药装置全程管理中国专家共识(2024版)
Expert consensus on the whole-course management of implantable venous access port in the upper arm of cancer patients (2024 edition)
恶性肿瘤是中国的重大公共卫生问题之一,其新发病例数和死亡人数逐年攀升。植入式静脉给药装置(IVAP)作为一种安全的输液途径被用于恶性肿瘤患者抗肿瘤药物的输注及静脉营养等治疗中。随着超声引导下塞丁格穿刺技术及心腔内电图定位技术的广泛应用,上臂IVAP因其完全避免了血胸、气胸风险且瘢痕隐蔽等优势,得到了广大医务人员和肿瘤患者的认可。为规范上臂IVAP在肿瘤患者中的临床应用,提高植入成功率、降低并发症、提高患者满意度,国家肿瘤质控中心乳腺癌专家委员会参考指南及循证证据,通过文献调研和专家讨论,制定了肿瘤患者上臂IVAP全程管理专家共识(2024版),旨在为上臂IVAP的规范应用提供参考依据。共识主要介绍了上臂IVAP的适应证、禁忌证、术前评估、植入部位、操作流程、使用及维护、相关并发症及处理、医务人员培训及患者教育等内容,以供广大临床工作者参考。
更多As one of a major public health issue in China, the number of new cases and deaths of malignant tumors has been climbing year by year. Implantable venous access port (IVAP) is used as a safe infusion route in the treatment of malignant tumor patients such as infusion of antitumor drugs and intravenous nutrition. With the widespread application of ultrasound-guided Sedinger puncture techniques and intracardiac electrocardiogram positioning technology, IVAP in the upper arm has been recognized by the majority of medical personnel and cancer patients due to its advantages of hiding scars and completely avoiding the risk of hemothorax and pneumothorax. In order to standardize the clinical application of IVAP via the upper arm approach in cancer patients, improve the success rate of implantation, reduce complications and improve patient satisfaction, the Breast Cancer Expert Committee of the National Cancer Quality Control Center consulted guidelines and the latest evidence-based evidences and established the expert consensus on the whole-course management of implantable venous access port in the upper arm of cancer patients through literature research and expert discussions, in order to provide reference for the standard application of IVAP in the upper arm. The consensus mainly introduces the indications, contraindications, preoperative evaluation, implantation site, operation procedure, utilization and maintenance, complications and management, medical staff training and patient education of IVAP in the upper arm, in order to provide reference for clinical staff.
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