摘要
目的 观察带涤纶环中心静脉留置导管在维持性血液透析患者中作为血管通路的效果及并发症.方法 我科自2005年12月至2012年5月共行带涤纶环中心静脉导管留置术105例次（103例）,男55例次（54例）,女50例次（49例）,年龄17～91岁,平均年龄（59±16.2）岁,均通过颈内静脉留置,术后拍摄胸片确定导管位置.以尿素清除率（URR）和Kt/V作为透析效果的客观评价指标.对照组则包含60例在同一时期使用相同设备,但使用动静脉内瘘进行血透的患者.结果 使用美国Quinton公司生产Permcath带涤纶环双腔导管经颈内静脉入路,99例次经右侧,6例次经左侧,使用1～54个月,平均使用（11.2±10.4）月.常见的并发症有：血流不畅27例169次,发生率4.79例次/1000导管日;感染32例34次,发生率0.96例次/1000导管日.导管组血流量（204±25） ml/min,URR值为（71.3±17.8）％,Kt/V值为（1.34±0.28）,与内瘘组比较差异无统计学意义.结论 对于无法行动静脉内瘘和人造血管移植手术的血液透析患者来说,带涤纶环中心静脉留置导管是一种有效的替代方法.
Objective To investigate the effect and complications of using dacron cuffed central venous catheter as vascular access in the patients undergoing maintenant hemodialysis.Methods 105 cuffed catheters were placed in 103 patients (55 catheters were placed in 54 male patients and 50 catheters in 49 female patients) as vascular access from December,2005 to May,2012.The mean age of these patients was (59.0 ± 16.2) years (range:17～91 years).All catheters were placed via internal jagular vein,and correct catheter placement was determined by X-ray.Urea reduction ratio (URR) and Kt/V were measured to assess the dialysis adequacy.The control group had 60 patients who received dialysis through internal arteriovenous fistulas simultaneously in the same unit.Results 105 catheters (PermCathTM Quinton Instrument) were placed via internal jugular vein (99 right side; 6 left side).Average duration was (11.2 ± 10.4) months (range:1～54 months).Frequent complications were thrombosis or occlusion (169 episodes occurred in 27 patients,at a rate of 4.79 episodes per 1000 catheter days) and infection (34 episodes occurred in 32 patients,at a rate of 0.96 episodes per 1000 catheter days).In the catheter group,the mean value of blood flow,URR,and Kt/V were (204 ± 25) ml/min,(71.3 ± 17.8)％ and (1.34 ± 0.28),respectively.There were no significant differences between the catheter group and the control group.Conclusions Dacron cuffed central venous catheter is an effective alternative vascular access especially for patients havig exhausted vascular access sites or patients unable to receive arteriovenous fistula and arteriovenous graft because of congestive heart failure.
出处
《国际医药卫生导报》
2013年第19期2974-2978,共5页
International Medicine and Health Guidance News
