中心静脉留置导管在血液透析中的应用

Application of central venous cattaeter (CVT) in hemodialisis

目的 总结中心静脉置管(CVT)在血液透析中的应用,探讨导管合理留置时间和并发症的防治。方法 回顾性分析九年间我院血液净化中心对783例急、慢性肾衰患者,穿刺股静脉、锁骨下静脉和颈内静脉三个部位CVT共806例次,其中股静脉192,锁骨下静脉263,颈内静脉351例次。结果 导管留置时间:股静脉3～45(18.7±12.2)天;锁骨下静脉14～171(43.9±27.8)天;颈内静脉16～92(43.6± 22.1)天。CVT并发症发生率为12.7％,常见的有感染(4.7％),血流不畅(3.2％),出血(2.0％),局部血肿(1.5％),深静脉血栓形成(1.2％)。结论 血透应用CVT有快捷、方便、安全的优点,导管留置时间:锁骨下和颈内静脉无显著性差异,但比股静脉明显延长。并发症的发生率股静脉最高,其次为锁骨下和颈内静脉。

Objective To review the complications and keeping duration for cential venous catheter (CVT) in hemodialisis patients. Methods 806 CVT procedures were performed in 593 renal failuie patients during last 9 years in this retrospective study.which include 192 femoral venous catheterization, 263 subclavian and 351 intemal jugular. Results Time of CVT were kept for: femaral: 3 - 45(18.7 + 12.2)days; subclavian: 14- 171(43.9 + 27.8)days; internai jugular: 16 - 92(43.6 + 22. 1)days. Comph'cations rate of CVT was 12.7%, which inelude infecn'on (4.7%) , thrombosis (3.2% ), hemoirhage(2.0%), local hematoma (1.5%),deep venous thrombosis (1.2%). Conclusions Our date diows diat the duration of CVT is subclavian equal to internai jungular, Subclavian and intemal jungular more than femoral. The incidence of com-plicatiori is femoral the most, subcalvinan more than internai jungular.