带CUFF中心静脉导管作为血液透析通路的临床分析

Analysis of cuffed central venous catheter undergoing hemodialysis

目的 总结留置带CUFF中心静脉导管的经验,探讨如何防治带CUFF中心静脉导管的并发症。方法 分析1996年3月～2001年3月我院对20例患者留置带CUFF中心静脉导管25例次。其中,右侧颈内静脉留置导管8例次、左侧颈内静脉留置导管2例次、右侧锁骨下静脉留置导管12例次、左侧锁骨下静脉留置导管3例次。结果 主要并发症:导管位置不当4例次;感染的发生率为32％(8/25),平均1.3例次/1000天,治疗有效率为25％(2/8);血栓的发生率为24％(6/25),导管内血栓治疗的有效率为75％(3/4)。总的带管时间为201个月,从2～27个月,平均带管时间为8个月。结论 带CUFF中心静脉导管对于长期血液透析治疗而无血管通路或不能承受动静脉内瘘的患者是必不可少的,其并发症是可以防治的。

Objective To review the complications of cuffed central venous catheter with its management.Methods A retrospetive study was performed in 25 cuffed central venous catheter procedures during the last five years,which include 8 right internal jugular catheterizations,2 left internal jugular catheterizations,12 right subclavian catheterizations,3 left subclavian catheterizations.Results The major complications include catheter malposition 4 of 25; infection 8 of 25 (32% ) (1 .3 episodes per 1000 catheter- days) ,2 (25% ) of the 8 cases were salvaged successfully; catheter thrombosis 6 of 25 (24% ),3(75% ) of the 4 cases in intraluminal thrombus were salvaged successfully.The cuffed central venous catheter was kept for 2 to 27 months,median 8 months.Conclusion Hemodialysis with cuffed central venous catheter in some patients who have exhausted all other access is essential and its complications can be controlled.