一2介入放射学杂志2023年1月第32卷第1期JIntervent Radiol2023Vdl32,No.l.指南与共识Guidelines and consensus·上臂完全植入式静脉给药装置临床应用专家共识(2022版)上海市医学会肿瘤内科专科分会，长三角肿瘤专科联盟【摘要】随着超声导引、Seldinger?穿刺技术及腔内心电定位技术等在经外周静脉置入中心静脉导管中的广泛应用，近年来经上臂完全植入式静脉给药装置(TIVAD)技术因完全避免血胸和气胸风险及颈、胸部无瘢痕等优势，被越来越多医护人员及患者所接受。目前国内从事此项工作的医护人员涉及内科外科、麻醉科、介入科等，植入技术、并发症处理及IVD使用、维护水平参差不齐，缺乏植入技术质控标准和并发症处理规范。为提高上臂TIVAD植入成功率，降低并发症发生率，保障忠者安全，特制定此专家共识。共识就技术适应证和禁忌证、操作流程、技术要点及并发症处理、使用维护等方面进行详细阐述，以期为临床医护人员提供参考。【关键词】完全植入式静脉给药装置；上臂；中心静脉导管；并发症；维护中图分类号：R473文献标志码：A文章编号：1008-794X(2023)-01-0002-07Expert consensus on the clinical application of totally implantable venous access devices in theupper arm (2022 Edition Oncology Chapter of Shanghai Medical Association,League of Oncology ofYangte River Delta RegionCorresponding author:OIU Xiaoxia (Affiliated Renji Hospital of Shanghai Jiao Tong University School ofMedicine),E-maik chouxiaoxia@renj.com:ZHANG Xuebin (Affiliated Renji Hospital of Shanghai Jiao TongUniversity School of Medicine),E-mail:zhangxuebin @renji.com:XU Lichao (Affiliated Cancer Hospital ofFudan University),E-mail:lichaoxul63@163.com[Abstract]With the wide application of ultrasound guidance,Seldinger puncture technique,andintracardiac electrical positioning technology in the placement of peripherally inserted central catheter(PICC)in recent years,the placement technology of the totally implantable venous access device (TIVAD)via the upper arm approach has been accepted by more and more medical staff and patients because it hasthe advantages of completely avoiding the risk of hemothorax,pneumothorax,and not causing neck and chestscar formation.At present,the medical staff engaged in this work in China involve internal medicine,surgery,anesthesiology,interventional departments,etc.In terms of implantation technology,the treatment ofcomplications,the use of TIVAD,the maintenance level,etc.the practical standards are uneven betweendifferent medical units,moreover,there are neither the quality control standards of implantation technologynor the handling specifications of complications so far.In order to improve the success rate of TIVADimplantation via the upper arm approach,reduce the complication rate,and ensure the patient safety,thisexpert consensus is thus proposed.This consensus elaborates on the technical indications andcontraindications,the operation process,the technical points,the treatment of complications,and the use andmaintenance about the placement technology of TIVAD,so as to provide a practical reference for clinicalmedical staff.[Key words]totally implantable venous access device:upper arm;central venous catheter;complication;maintenanceD01:10.3969j.issn.1008-794X2023.01.001通信作者：仇晓霞（上海交通大学医学院附属仁济医院）E-mail:chouxiaoxia@renji.com张学彬（上海交通大学医学院附属仁济医院）E-mail:小angxuebin@renji..com许立超（复旦大学附属肿瘤医院）E-mail:lichaoxul63@163.com(C)1994-2023 China Academic Journal Electronic Publishing House.All rights reserved.http://www.cnki.net
