右颈内静脉留置涤纶环导管在血液透析中的应用

Application of Cuffed Catheter in Right Internal Jugular Vein in Hemodialysis

目的:探讨右颈内静脉留置涤纶环导管在维持性血液透析中的应用价值。方法:为41例维持性血液透析患者留置右颈内静脉涤纶环双腔导管作为血透用血管通路并观察其临床应用情况。结果:⑴导管留置时间(14.3±10.5)月,经导管血透时血流量200～300mL/min;⑵导管使用终点12例次,导管退出时平均使用时间(8.2±6.1)月;⑶术后渗血或血肿发生率43.9%,导管位置不良发生率2.4%;⑷平均感染率0.586次/100导管日,导管血栓发生率31.7%;⑸尿素下降比例为(71.5±0.06)%,尿素清除指数(KT/V)为1.42±0.19。结论:对维持性血液透析患者,右颈内静脉留置涤纶环导管是一种安全有效的血管通路方式。

Objeotive To investigate the value of cuffed catheter indwelling in right internal jugular vein in maintenance of hemodialysis. MethOds Forty-one cases were implanted dual-lumen cuffed catheters in right jugular vein as vascular access, and the clinical efficacy and complications were observed. Results （1）The indwelling time of the catheters were （ 14. 3 ± 10.5 ） months, the blood flow was from 200 mL/min to 300 mL/min;（2）The endpoint of catheters was 12 case-times, the using time of catheters were （ 8.2 ± 6.1 ） months at the endpoint; （3）The incidence of hemorrhage or haematoma was 43. 9%, the rate of catheter malposition was 2.4% ;（4）The average incidence of the catheter related infection was 0. 586 per 100 catheters days and the incidence of catheter thrombosis was 31.7% ;（5）The decline rate of urea was （71.5 ± 0.06） % and the KT/V（urea） was 1.42 ±0.19 in 41 cuffed catheter eases. Conclusion Cuffed catheter in right internal jugular vein is a safe and effective vascular access in maintenance of hemodialysis.