查詢結果分析
相關文獻
- Transesophageal Echocardiography and Laryngeal Mask Airway for Placement of Permanent Central Venous Catheter in Cancer Patients with Radiographically Unidentifiable SVC-RA Junction: Effectiveness and Safety
- Multiplane Transesophageal Echocardiography in the Diagnosis of Sinus Venosus Atrial Septal Defect in Adults
- Diagnosis of Pulmonary Sequestration by Transesophageal Echocardiography: Report of Two Cases
- Transesophageal Echocardiography of a Patient with Fenestrated Type Atrial Septal Defect
- Comparisons of Clinical Presentations and Hospital Outcome between Type A & Type B Aortic Dissections--Six Years' Experience
- Diagnosis of Progressive Compression of the Aortic True Lumen with Intraoperative Transesophageal Echocardiography during Repair of Dissection of Thoracic Aorta:A Case Report
- Bedside Pericardiocentesis under the Guidance of Transesophageal Echocardiography in a 13-Month-Old Boy
- Left Atrial Vegetation in a Patient with Mitral Regurgitation: Transesophageal Echocardiographic Findings
- 經食道心臟超音波(TEE)在急重症照護的應用
- Delayed Diagnosis of Esophageal Perforation Following Intraoperative Transesophageal Echocardiography during Valvular Replacement--A Case Report
頁籤選單縮合
題名 | Transesophageal Echocardiography and Laryngeal Mask Airway for Placement of Permanent Central Venous Catheter in Cancer Patients with Radiographically Unidentifiable SVC-RA Junction: Effectiveness and Safety=X光無法辨識上腔靜脈右心房交接處的癌症病人以喉罩通氣道及經食道心臟超音波配合植入長期中央靜脈導管之效果與安全性 |
---|---|
作者 | 徐仲豪; 王建國; 洪雀雯; 王世憲; 程廣義; 吳俊仁; | 書刊名 | The Kaohsiung Journal of Medical Sciences |
卷期 | 23:9 2007.09[民96.09] |
頁次 | 頁435-441 |
分類號 | 416.264 |
關鍵詞 | 喉罩通氣道; 長期中央靜脈導管; 上腔靜脈右心房交接處; 經食道心臟超音波; Laryngeal mask airway; Permanent central venous catheter; SVC-RA junction; Transesophageal echocardiography; |
語文 | 英文(English) |
中文摘要 | 植入長期中央靜脈導管時,導管尖端常放在上腔靜脈與右心房交接處。目前並無報告顯示,病人 X 光片無法辨識上腔靜脈右心房交接處時,放置長期中央靜脈導管,該如何定位。本前瞻性研究的目的有:(1) 需要植入長期中央靜脈導管的癌症病人,X 光片無法辨識上腔靜脈右心房交接處的發生率及原因。(2) 無法辨識此交接處之病人,在植入長期中央靜脈導管時,以喉罩通氣道 (LMA) 結合經食道心臟超音波 (TEE) 協助導管定位的可行性、有效性及安全性。研究以一年時間,篩檢醫學中心連續 83 位需要植入長期中央靜脈導管之成年癌症病人。放射線醫師先判讀病人之術前 X 光片以檢視其上腔靜脈右心房交接處可否被辨識,分類無法辨識之原因與癌症相關或非相關。對於交接處無法辨識的病人,在植入長期中央靜脈導管時,以小兒雙平面 TEE 探頭配合 LMA,於靜脈麻醉下,將導管導引至上腔靜脈右心房交接處。有 16% (13/83) 的病人無法在 X 光片辨識上腔靜脈右心房交接處,其原因只有 23% (3/13) 與癌症相關。此 13 位病人的 LMA 皆在 TEE 探頭置入後成功地放置、無漏氣情形發生,且導管尖端均成功地放置於上腔靜脈右心房交接處。結論:16% 之癌症病人無法以 X 光片辨識上腔靜脈右心房交接處,其原因大多與癌症非相關。這些病人、在 LMA 全身麻醉下,以 TEE 導引長期中央靜脈導管至上腔靜脈右心房交接處,是一個可行、安全及有效之方法。 |
英文摘要 | In patients who require a permanent central venous catheter (PCVC), the usual aim is to put the catheter tip at the superior vena cava and right atrium (SVC-RA) junction. However, there is no study regarding how to guide the positioning of the catheter tip when the SVC-RA junction cannot be identified on chest radiograph. The objectives of this prospective study were: (1) to investigate the incidence and etiologies of radiographically undetermined SVC-RA junctions in cancer patients undergoing PCVC implantation; and (2) to evaluate the feasibility, effectiveness and safety of combined transesophageal echocardiography (TEE) and laryngeal mask airway (LMA) to guide the positioning of catheters during implantations in patients without this radiographic landmark. Over a 1-year study period, 83 consecutive patients with oncologic diseases who required implantation of a PCVC in a tertiary center were screened. Their preoperative chest radiographs were examined by radiologists to identify the presence of the SVC-RA junction. Patients without a radiographically identifiable SVC-RA junction were classified as cancer-related or cancer-unrelated in terms of etiology. For patients without this landmark, we used TEE with a pediatric biplane transducer and a LMA under intravenous general anesthesia during PCVC implantation to guide the positioning of the catheter tip at the SVC-RA junction. We found that in 16% (13/83) of patients, the SVC-RA junction could not be identified on radiograph. Among the 13 patients, only three (23%) had cancer-related etiologies. In all of the 13 patients, the LMA was successfully placed after the TEE transducer was inserted. No episode of air leak from the LMA was found during surgery. All had the catheter tip positioned in the anatomic SVC-RA junction under TEE guidance. In conclusion, 16% of cancer patients requiring PCVC implantation had no identifiable SVC-RA junction on chest radiograph and most causes were cancer-unrelated. In patients without a radiographically identifiable SVC-RA junction, guidance by TEE under LMA general anesthesia is a feasible, safe and effective management to position a PCVC at the SVC-RA junction. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。