摘要
目的探讨股静脉带隧道带涤纶套导管(tunneled-cuffed catheter,TCC)作为血液透析过渡通路的可行性。方法回顾性分析2016年11月至2020年11月上海中医药大学附属龙华医院31例使用股静脉TCC作为过渡期血液透析通路患者的导管应用效果,包括置管情况、血透情况、留置时间、导管感染发生率和下肢深静脉血栓形成、中心静脉病变、纤维鞘等并发症发生率。结果患者均一次置管成功,平均留置时间(77.74±74.54)d。留置期间出现导管功能不良5例,感染2例。新发中心静脉病变5例,新发导管局部附壁血栓4例。新发中心静脉病变组导管平均留置时间为(151.80±161.45)d明显长于无新发中心静脉病变组导管平均留置时间(63.5±34.49)d,差异有统计学意义(P=0.041)。18例拔管患者造影示13例(72.22%)纤维鞘形成。患者均无下肢深静脉血栓形成,无中心静脉闭塞病变。结论股静脉TCC能满足血液透析的需求,并发症发生率在可接受范围内,可推荐作为过渡期血透通路。
Objective To explore the feasibility of femoral vein tunneled-cuffed catheter(TCC)as transitional hemodialysis access.Methods The clinical safety and effectiveness,including catheter placement,hemodialysis,intubation time,infection rate and incidence of complications such as deep vein thrombosis,central venous disease and fibrous sheath,of 31 patients using femoral vein TCC as transitional hemodialysis access at Longhua Hospital,Shanghai University of Traditional Chinese Medicine between November 2016 and November 2020 were analyzed retrospectively.Results All cases were successfully catheterized at one time,and the average time of indwelling were(77.74±74.54)days.The catheter dysfunction was occurred in 5 cases during the intubation period,while two cases were infected.There were five cases of emerging central venous disease and four cases of emerging local wall thrombus of catheter.The mean time of catheter intubation in the emerging central venous disease group was(151.80±161.45)days,which was significantly longer than that of the non-emerging central venous disease group[(63.5±34.49)days],and the difference was statistically significant(P=0.041).Contrast-enhanced examination of 18 patients with extubation showed that fibrous sheaths were formed in 13 cases(72.22%).All cases had no deep vein thrombosis of lower extremity nor central vein occlusion.Conclusion The femoral vein TCC can fulfil the needs of hemodialysis and the incidence of complications is acceptable,which can be recommended as a transitional hemodialysis access.
作者
刘思洁
施娅雪
鲍雪东
米兰化
于敏
胡文平
吴厂
Liu Sijie;Shi Yaxue;Bao Xuedong;Mi Lanhua;Yu Min;Hu Wenping;Wu Chang(Department of Vascular Surgery,Longhua Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China)
出处
《中国血管外科杂志（电子版）》
2022年第1期48-51,60,共5页
Chinese Journal of Vascular Surgery(Electronic Version)
