摘要
目的探讨延长临时性中心静脉导管使用期限及影响因素的防治方法。方法对本组243例临时性导管置管患者应用情况总结,观察置管部位、效果、舒适度、并发症对留置时间的影响。结果(1)采用右颈内静脉置管144例,成功率98%,经股静脉置管75例,成功率99%,经右锁骨下静脉置管24例,成功率95%。(2)导管血流量、透析前后尿素下降率、透析充分性Kt/V值等同长期留置导管和内瘘比较差异无显著性(P>0.05)。(3)导管平均使用时间:与长期导管(7.0±6.5月vs10.7±7.4月)比较有显著差异(P<0.05)。(4)导管退出原因:感染、导管功能不良,其余为内瘘成熟、肾移植和死亡。其中感染65例发生率,平均感染率2.92次/1000导管天;治疗有效58例,拔管7例。病原菌:金黄色葡萄球菌、表皮葡萄球菌、大肠埃希菌、阴沟杆菌等。结论临时性导管易操作并发症少,感染与导管功能不良是影响长期留置的主要因素,选择合适置管部位,严格的局部护理及感染的早期检测和及时处理是延长留置期限的关键。
Objective To probe into prolonging possibility of provisionality central venous catheters used and method of prevention and cure affect factors in clinic.Methods To sum up 243 cases installed with provisionality central venous catheters in order to observe position、 effect、 comfort、complication of influence to the using period.Results Among the 243 cases ,one hundred and forty-four were implanted in the right internal jugular vein, 75 cathetersin the thigh vein and 24 cathetersin the subclavian vein. The result in adequacy which compared the provisionality catheters with long-term catheters and arterio-venous fistula was no difference(P>0.05).The average of using time were7.0±6.5months,that was as following 115 cases longer than or equal to 6 months, 29 cases longer than or equal to 12 months and 69 cases shorter than 3 months; It was different of holding time between the short catheters and the long catheters(P<0.05).The catheters exit causes were infection、dysfunction、dilatation of arterio-venous fistula 、renal transplantation and death. The bacteria were staphylococcus aureus、staphylococcus epidermidis et al.Conclusion The provisionality catheters have benefit of operating easily、less complication .Only to choose the right position to intubate catheter、to nurse well、to diagnose early and treatment properly,can the short catheters be used much longer.
出处
《中国医药导报》
CAS
2006年第12期1-3,共3页
China Medical Herald
关键词
血液透析
中心静脉导管
并发症
长期留置
Hemodialysis
Central venous catheters
Complication
Preserving time
