股静脉穿刺置管在血液净化中临床应用

目的股静脉穿刺置管在血液净化中的应用价值。方法对98例血液透析患者进行股静脉置管,对其成功率、并发症进行分析。结果 98例患者共接受股静脉置管,一次性成功率达96.9%(95例),96%(94例)患者血流量能达到220ml/min以上,误穿动脉导致局部血肿发生4例,局部按压20分钟自行吸收,重新穿刺或行对侧股静脉置管;局部渗血2例,局部压迫后止血。导管相关感染方面,使用肝素盐水+抗生素混合封管后,均能消除症状。发生导管静脉血栓形成可用尿激酶溶液溶栓处理。总之,股静脉置管术能很好地用于血液透析患者,操作容易、方便快捷,且严重并发症少。结论股静脉穿刺置管成功率高,并发症少,是一种比较理想的临时性血管通路。主要适用于急性肾衰、慢性肾衰、手臂内瘘成熟前、食物和药物中毒等血液透析治疗。特别适合于基层医疗单位操作欠熟练初学者。

Objective femoral vein catheterization in the value of blood purification Methods 98 cases of hemodialysis patients with femoral vein,its success rate,complications.Results A total of 98 patients received femoral vein,one-time success rate of 96.9%（95 patients）,96%（94 patients） blood flow can reach 220 ml /min or more,errors occur through arteries leading to localized hematoma 4 cases,the local press for 20 minutes self-absorption,re-puncture or contralateral femoral vein;local bleeding in 2 cases,partial compression of bleeding.Catheter-related infection,the use of heparin mixed saline ＋ antibiotics sealed tube,can eliminate symptoms.Venous catheter thrombosis occurred.Thrombolytic treatment with urokinase solution available.In short femoral vein catheterization is well for hemodialysis patients,easy,convenient,and less severe complications.Conclusion Femoral venous catheterization success rate and few complications,is an ideal temporary vascular access.Mainly applicable to acute renal failure,chronic renal failure,pre-arm fistula maturation,food and drug poisoning and other blood dialysis.Particularly suitable for primary health care units operating less skilled beginners.