锁骨下静脉上位置管与颈内静脉置管在血液透析中比较

Comparison between epistatic subclavian vein and internal jugular vein catheterization with double-lumen in hemodialysis

目的 比较锁骨下静脉上位置管与颈内静脉置管建立临时性血液透析通路的优缺点。方法 采用回顾性对照研究 ,98例急需血液透析患者先后采用锁骨下静脉上位置管 6 8例 ,颈内静脉置管 30例。观察两种插管途经的穿刺成功率、完成插管时间、导管留置时间、导管相关并发症、血流量及Kt/V值等。结果 锁骨下静脉上位穿刺成功率 94 .1% ,显著高于颈内静脉 80 .0 % (P <0 .0 1) ,完成插管时间亦优于颈内静脉 (P <0 .0 5 ) ;锁骨下静脉上位插管的留置时间明显长于颈内静脉插管 (P <0 .0 5 ) ,锁骨下静脉上位置管的血流量不足、感染及导管堵塞发生率均低于颈内静脉置管 (P <0 .0 5 ) ,两部位插管的Kt/V值无显著性差异 (P >0 .0 5 )。结论 相对而言 。

objective To compare the advantages and disad vantages of epistatic subclavian vein catheterization (ESVC) with that of internal jugular vein catheterization (IJVC) in hemodialysis. Methods Sixty-eight ESV C and 30 IJVC were performed in 98 hemodialysis patients rate of puncture success, catheterization time, the catheters' survival life, complications, blood flow and Kt/V were observed retrospectively. Results Rate of puncture success of ESVC was significantly higher than that of IJVC (94.1% vs 80% respectively P<0.05) and catheterization time of ESVC was shorter obviously than that of IJVC (P<0.05); The survival life of ESVC was longer significantly than that of IJVC (P<0.05) and a lower incidence of infection, inadequate blood flow and obstruction were also found; Kt/V of ESVC and IJVE was of no significant difference (P>0.05).Conclusions ESVC is relatively an ideal temporary blood access for hemodialysis.