【摘要】 目的：探讨经皮锁骨下动脉穿刺插管的适应证，操作技术及并发症。方法：６６例胸部、腹部及盆腔恶性肿瘤患者中，６０例行经皮左锁骨下动脉导管药盒植入术，６例因严重动脉粥样硬化作股动脉穿刺插管和／或选择或超选择肝动脉和髂内动脉插管失败，而行经皮左锁骨下动脉穿刺插管共７２人次。经左锁骨中外三分之一下２ｃｍ向内上或水平穿刺。用Ｓｅｌｄｉｎｇｅｒ法把导管顺向引入靶动脉，然后再行血管造影和介入治疗或导管药盒系统植入。结果：穿刺锁骨下动脉，选择或超选择肝动脉，肠系膜上、下动脉，髂内动脉及它们分支动脉和支气管动脉插管共８８次，均获成功。发生局部血肿１１例，无气胸、血胸等重要并发症发生。结论：熟悉经皮锁骨下动脉穿刺插管对导管药盒系统的植入及不适应作经皮股动脉穿刺插管或经股动脉穿刺插管作选择或超选择靶血管有困难和失败者有意义。更多还原

【Abstract】 Objective:To evaluate the indication,operating techique and complications of percutaneous left subclavian artery(LSA) puncture for catheterization.Methods:The approach was performed in 66 patients with thoracic abdominal or pelvic malignant tumors,including:port-catheter-system(PCS)implantation via LSA in 60 cases,alternative approaches in 6 cases because of either severe atherosclerosis or/and failure in selective proper hepatic arterial of iliac arterial catheterization.Diagnostic and therapic operations were performed after the catheters were inserted into target arteries via a puncture site 2 cm below intermediolateral one-third of lefe clavicle.Results:After puncture of LSA,selective catheterization of bronchial artery,hepatic artery and its braches,superior or inferior mesenteric artery and internal iliac artery were successfully achieved in 88 fimes.There were not significant complictions (such as pneuothorax,hemothorax) were developed except 11 cases with local hemorrhages. Conclusion:Percutareous LSA catheterization for PCS implantation and unsuccessful selective or super-selective catheterization via femur artery is a safe and reliable apprach.更多还原