经颈外静脉入路长期深静脉留置导管在维持性血液透析患者中的应用

Application of long-term indwelling cuffed catheter in external jugular vein for hemodialysis

目的回顾性分析经颈外静脉入路的长期带涤纶套深静脉置管在维持性血液透析患者中的应用．探讨其安全性和可行性。方法选择2003年6月至2008年6月在我院行颈外静脉入路的带涤纶套长期深静脉置管患者为观察组，共行置管术90例次；选择同期经颈内静脉入路长期深静脉置管患者为对照组，共行置管术304例次。比较2组导管使用寿命、透析充分性、退出原因及并发症发生情况。结果（1）2组导管平均生存时间分别为（34．2±3．9）个月、（32．6±2．3）个月，95％可信区间分别为（26．5441．8）个月、（28．1～37．2）个月，中位生存时间分别为31）、31个月，差异均无统计学意义（χ^2=1．060，P〉0．05）；（2）2组Kt／V分别为（1．49±0．36）、（1．50±0．41），差异无统计学意义（P〉0．05）；（3）2组感染和血栓的发生率均无统计学差异（P〉0.05）。结论经颈外静脉人路长期深静脉置管是一种安全、有效的方法。

Objective To analyze the application of long-term indwelling cuffed catheter in external jugular vein for hemodialysis,and explore the security and feasibility. Methods External jugular vein were used for the site of catheter implantation in 90 attempts, internal jugular vein was used for the site of catheter implantation in 31）4 attempts. The mean lifetime of the catheter, Kt/V and complication were compared between two groups. Results （1） The mean lifetime of the catheter appeared to be （34. 165 ± 3. 897） months （95% CI of 26. 526±41. 8113） and the median lifetime was 30 months in observation group. The mean lifetime of the catheter appeared to be （32. 648 ± 2. 338） months （95% CI of 28. 065～37. 23/）） and the median lifetime was 31 months in control group. There was no significant difference in the lifetime of the catheters between two groups （χ2=1. 060, P〉0. 05）;（2） There was no significant difference in Kt/V between two groups（P〉0. 05）;（3）These was no significant in complication between two groups（P〉0. 05）. Conclusion External jugular vein used for the site of catheter is an effective and safe implanting technique for long-term cuffed catheters in hemodialysis patients.