大腸がん患者における埋め込み式中心静脈カテーテル閉塞のリスク因子解析
【目的】CVポート留置による合併症を回避することは, 抗がん剤治療, 緩和医療を受ける症例にとって重要である. 【方法】2006年10月～2011年12月に, 岡山大学病院 腫瘍センターでCVポートを介して外来化学療法を施行した大腸がん患者68例におけるCVポート関連合併症を後方視的に検討した. 【結果】CVポート関連トラブルを20例(29.4％) に認め, そのうちルート閉塞または逆血不可を15例に認めた. この15例中, 10例は逆血不可以外の合併症なく, 継続して抗がん剤投与が可能であったが, 残り5例はさらなる合併症のため, CVポートの入れ替えが必要であった. 鎖骨下静脈穿刺・左側静...
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| Published in | Palliative Care Research Vol. 8; no. 1; pp. 135 - 141 |
|---|---|
| Main Authors | , , , , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
日本緩和医療学会
2013
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 1880-5302 |
| DOI | 10.2512/jspm.8.135 |
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| Abstract | 【目的】CVポート留置による合併症を回避することは, 抗がん剤治療, 緩和医療を受ける症例にとって重要である. 【方法】2006年10月～2011年12月に, 岡山大学病院 腫瘍センターでCVポートを介して外来化学療法を施行した大腸がん患者68例におけるCVポート関連合併症を後方視的に検討した. 【結果】CVポート関連トラブルを20例(29.4％) に認め, そのうちルート閉塞または逆血不可を15例に認めた. この15例中, 10例は逆血不可以外の合併症なく, 継続して抗がん剤投与が可能であったが, 残り5例はさらなる合併症のため, CVポートの入れ替えが必要であった. 鎖骨下静脈穿刺・左側静脈穿刺によるCVポート留置が, ルート閉塞のリスク因子であった. 【結論】CVポート関連合併症のうち, 特に逆血不可の症例に関して約1/3は潜在的にCVポートの入れ替えが必要な可能性があることを認識すべきである. |
|---|---|
| AbstractList | 【目的】CVポート留置による合併症を回避することは, 抗がん剤治療, 緩和医療を受ける症例にとって重要である. 【方法】2006年10月～2011年12月に, 岡山大学病院 腫瘍センターでCVポートを介して外来化学療法を施行した大腸がん患者68例におけるCVポート関連合併症を後方視的に検討した. 【結果】CVポート関連トラブルを20例(29.4％) に認め, そのうちルート閉塞または逆血不可を15例に認めた. この15例中, 10例は逆血不可以外の合併症なく, 継続して抗がん剤投与が可能であったが, 残り5例はさらなる合併症のため, CVポートの入れ替えが必要であった. 鎖骨下静脈穿刺・左側静脈穿刺によるCVポート留置が, ルート閉塞のリスク因子であった. 【結論】CVポート関連合併症のうち, 特に逆血不可の症例に関して約1/3は潜在的にCVポートの入れ替えが必要な可能性があることを認識すべきである. |
| Author | 井上, 佳子 西森, 久和 藤田, 百惠 福武, 恵 高下, 典子 松島, 幸枝 平田, 泰三 堀田, 勝幸 西本, 仁美 田端, 雅弘 露無, 祐子 久山, めぐみ |
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| References | 13) Seddighzadeh A, Shetty R, Goldhaber SZ. Venous thromboembolism in patients with active cancer. Thromb Haemost 2007; 98: 656-61. 8) De Cicco M, Matovic M, Balestreri L, et al. Central venous thrombosis: an early and frequent complication in cancer patients bearing long-term silastic catheter. A prospective study. Thromb Res 1997; 86: 101-13. 16) Jansen FH, van der Straaten HM, Roest M, et al. Elevated levels of D-dimer and fragment 1+2 upon central venous catheter insertion and factor V Leiden predict subclavian vein thrombosis. Haematologica 2005; 90: 499-504. 11) Caers J, Fontaine C, Vinh-Hung V, et al. Catheter tip position as a risk factor for thrombosis associated with the use of subcutaneous infusion ports. Support Care Cancer 2005; 13: 325-31. 4) Saber W, Moua T, Williams EC, et al. Risk factors for catheter-related thrombosis (CRT) in cancer patients: a patient-level data (IPD) meta-analysis of clinical trials and prospective studies. J Thromb Haemost 2011; 9: 312-9. 17) Couban S, Goodyear M, Burnell M, et al. Randomized placebo-controlled study of low-dose warfarin for the prevention of central venous catheter-associated thrombosis in patients with cancer. J Clin Oncol 2005; 23: 4063-9. 3) Boersma RS, Jie KS, Verbon A, et al. Thrombotic and infectious complications of central venous catheters in patients with hematological malignancies. Ann Oncol 2008; 19: 433-42. 7) Verso M, Agnelli G, Kamphuisen PW, et al. Risk factors for upper limb deep vein thrombosis associated with the use of central vein catheter in cancer patients. Intern Emerg Med 2008; 3: 117-22. 2) Vescia S, Baumgärtner AK, Jacobs VR, et al. Management of venous port systems in oncology: a review of current evidence. Ann Oncol 2008; 19: 9-15. 15) Carrier M, Lee AY, Bates SM, et al. Accuracy and usefulness of a clinical prediction rule and D-dimer testing in excluding deep vein thrombosis in cancer patients. Thromb Res 2008; 123: 177-83. 12) Sutherland DE, Weitz IC, Liebman HA. Thromboembolic complications of cancer: epidemiology, pathogenesis, diagnosis, and treatment. Am J Hematol 2003; 72: 43-52. 1) Mansfield PF, Hohn DC, Fornage BD, et al. Complications and failures of subclavian-vein catheterization. N Engl J Med 1994; 331: 1735-8. 6) Cadman A, Lawrance JA, Fitzsimmons L, et al. To clot or not to clot? That is the question in central venous catheters. Clin Radiol 2004; 59: 349-55. 9) Revel-Vilk S, Yacobovich J, Tamary H, et al. Risk factors for central venous catheter thrombotic complications in children and adolescents with cancer. Cancer 2010; 116: 4197-205. 10) Puel V, Caudry M, Le Métayer P, et al. Superior vena cava thrombosis related to catheter malposition in cancer chemotherapy given through implanted ports. Cancer 1993; 72: 2248-52. 14) ten Wolde M, Kraaijenhagen RA, Prins MH, et al. The clinical usefulness of D-dimer testing in cancer patients with suspected deep venous thrombosis. Arch Intern Med 2002; 162: 1880-4. 18) Karthaus M, Kretzschmar A, Kröning H, et al. Dalteparin for prevention of catheter-related complications in cancer patients with central venous catheters: final results of a double-blind, placebo-controlled phase III trial. Ann Oncol 2006; 17: 289-96. 19) Verso M, Agnelli G, Bertoglio S, et al. Enoxaparin for the prevention of venous thromboembolism associated with central vein catheter: a double-blind, placebo-controlled, randomized study in cancer patients. J Clin Oncol 2005; 23: 4057-62. 5) Gould JR, Carloss HW, Skinner WL. Groshong catheter-associated subclavian venous thrombosis. Am J Med 1993; 95: 419-23. |
| References_xml | – reference: 6) Cadman A, Lawrance JA, Fitzsimmons L, et al. To clot or not to clot? That is the question in central venous catheters. Clin Radiol 2004; 59: 349-55. – reference: 17) Couban S, Goodyear M, Burnell M, et al. Randomized placebo-controlled study of low-dose warfarin for the prevention of central venous catheter-associated thrombosis in patients with cancer. J Clin Oncol 2005; 23: 4063-9. – reference: 19) Verso M, Agnelli G, Bertoglio S, et al. Enoxaparin for the prevention of venous thromboembolism associated with central vein catheter: a double-blind, placebo-controlled, randomized study in cancer patients. J Clin Oncol 2005; 23: 4057-62. – reference: 11) Caers J, Fontaine C, Vinh-Hung V, et al. Catheter tip position as a risk factor for thrombosis associated with the use of subcutaneous infusion ports. Support Care Cancer 2005; 13: 325-31. – reference: 7) Verso M, Agnelli G, Kamphuisen PW, et al. Risk factors for upper limb deep vein thrombosis associated with the use of central vein catheter in cancer patients. Intern Emerg Med 2008; 3: 117-22. – reference: 4) Saber W, Moua T, Williams EC, et al. Risk factors for catheter-related thrombosis (CRT) in cancer patients: a patient-level data (IPD) meta-analysis of clinical trials and prospective studies. J Thromb Haemost 2011; 9: 312-9. – reference: 15) Carrier M, Lee AY, Bates SM, et al. Accuracy and usefulness of a clinical prediction rule and D-dimer testing in excluding deep vein thrombosis in cancer patients. Thromb Res 2008; 123: 177-83. – reference: 8) De Cicco M, Matovic M, Balestreri L, et al. Central venous thrombosis: an early and frequent complication in cancer patients bearing long-term silastic catheter. A prospective study. Thromb Res 1997; 86: 101-13. – reference: 2) Vescia S, Baumgärtner AK, Jacobs VR, et al. Management of venous port systems in oncology: a review of current evidence. Ann Oncol 2008; 19: 9-15. – reference: 10) Puel V, Caudry M, Le Métayer P, et al. Superior vena cava thrombosis related to catheter malposition in cancer chemotherapy given through implanted ports. Cancer 1993; 72: 2248-52. – reference: 3) Boersma RS, Jie KS, Verbon A, et al. Thrombotic and infectious complications of central venous catheters in patients with hematological malignancies. Ann Oncol 2008; 19: 433-42. – reference: 14) ten Wolde M, Kraaijenhagen RA, Prins MH, et al. The clinical usefulness of D-dimer testing in cancer patients with suspected deep venous thrombosis. Arch Intern Med 2002; 162: 1880-4. – reference: 12) Sutherland DE, Weitz IC, Liebman HA. Thromboembolic complications of cancer: epidemiology, pathogenesis, diagnosis, and treatment. Am J Hematol 2003; 72: 43-52. – reference: 9) Revel-Vilk S, Yacobovich J, Tamary H, et al. Risk factors for central venous catheter thrombotic complications in children and adolescents with cancer. Cancer 2010; 116: 4197-205. – reference: 16) Jansen FH, van der Straaten HM, Roest M, et al. Elevated levels of D-dimer and fragment 1+2 upon central venous catheter insertion and factor V Leiden predict subclavian vein thrombosis. Haematologica 2005; 90: 499-504. – reference: 1) Mansfield PF, Hohn DC, Fornage BD, et al. Complications and failures of subclavian-vein catheterization. N Engl J Med 1994; 331: 1735-8. – reference: 5) Gould JR, Carloss HW, Skinner WL. Groshong catheter-associated subclavian venous thrombosis. Am J Med 1993; 95: 419-23. – reference: 13) Seddighzadeh A, Shetty R, Goldhaber SZ. Venous thromboembolism in patients with active cancer. Thromb Haemost 2007; 98: 656-61. – reference: 18) Karthaus M, Kretzschmar A, Kröning H, et al. Dalteparin for prevention of catheter-related complications in cancer patients with central venous catheters: final results of a double-blind, placebo-controlled phase III trial. Ann Oncol 2006; 17: 289-96. |
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| Snippet | 【目的】CVポート留置による合併症を回避することは, 抗がん剤治療, 緩和医療を受ける症例にとって重要である. 【方法】2006年10月～2011年12月に, 岡山大学病院 腫... |
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| SubjectTerms | リスク因子 合併症 埋め込み式中心静脈カテーテル(CVポート) 外来化学療法 大腸がん |
| Title | 大腸がん患者における埋め込み式中心静脈カテーテル閉塞のリスク因子解析 |
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