摘要
目的观察长期深静脉双腔留置导管在血液透析中的使用效果，总结长期留置导管经验。方法随访自2003年8月至2008年2月68例长期留置深静脉双腔导管的透析患者的使用情况和并发症。结果实施长期深静脉双腔导管留置手术68例，均经右侧颈内静脉一次性成功（成功率为100％）；导管退出时平均使用时间12．8～7．3个月，退出原因：分别为死亡、感染、血栓形成、导管破裂、肾移植、内瘘；导管使用期限：平均（16．4±8．14）个月，使用时间分别为大于36个月1例，大于24个月8例，大于12个月29例，大于6个月19例，小于6个月11例。长期深静脉双腔留置导管透析效果：导管血流量、透析充分性KT／V值和内瘘比较差异无显著性（P〉0．05）。结论长期深静脉双腔留置导管适用于维持性血液透析患者，可以达到充分透析；成功的置管，严格的管理，有效处理并发症是延长导管使用期限的重要保证。
Objective To observe the effect of long-term cuffed catheter for maitenance hemodialysis patients and summarize the experience. Methods 68 cases of cuffed catheters for long-term blood access of HD patients were observed from 2003-2008 year in our hospital. The survival and complications of each cuffed catheter implanted were followed up and recorded. Results 1. cuffed cathettrs for long term blood access was implanted in 68 cases of chronic renal failure patients. Internal jugular vein was used for the site of catheter implantation in all patients. 2. The average survival of the total catheter implanted was 16.4 ± 8. 14 months catheter survival over 36 months was observed in 1 case. Survival over 24 months in 8 cases, sur- vival over 12 months in 29 eases. Survival over 6 months in 19 cases. Survival below 6 months in 11 eases, Aver- age survival of the end of catheter usage was 12. 8 ± 7. 3 months, complications resulted the ending of catheter usage, included death. Infections. Catheter damage, thrombosis, internal fistula, renal transplantation to difference of dialysis adequacy was found between the patients inplanted with cuffed catheter and that of arterio-venous fis- tula（ P 〉 0.05 ）. Conclusion long-term cuffed catheter is as effective as A-V fistula for blood access in minte- nanee HD patients. Effecttive and long term usage of cuffed catheters in HD patients demand good catheter im- planting and careful nursing.
出处
《中国临床实用医学》
2008年第9期15-17,共3页
China Clinical Practical Medicine
