手术取栓治疗颈内静脉留置涤纶套导管内血栓的评价

Clinical evaluation on thrombus-removed operation against thrombus of cuffed catheters in jugular vein

目的探讨右颈内静脉留置长期涤纶套导管内血栓经溶栓失败后行手术取栓法的应用价值。方法评价9例次右颈内静脉留置涤纶套双腔导管的患者发生导管内血栓者经溶栓失败后行手术取栓术(A组)和9例次新穿刺右颈内静脉留置涤纶套中心静脉导管(B组)的临床应用情况。结果①A组和B组导管中位生存时间分别为20、22个月,生存曲线差异无统计学意义(P>0.05)。②与B组比较,A组插管处局部皮肤感染率和导管引起的全身感染发生率、使用导管透析时血流量、导管血栓发生率以及出血性并发症的差异均无统计学意义(P>0.05);两组均无纤维鞘形成。结论对于溶栓失败的右颈内静脉留置涤纶套导管内血栓形成的患者,手术取栓法治疗安全有效。

Objective To evaluate thrombus-removed operation against thrombus of cuffed catheters in jugular vein.Method Compared with 9 cuffed catheters inserted by puncturation of right jugular vein（B group）,thrombus-removed operation against thrombus of cuffed catheters in right jugular vein（A group） were observed.Result Median survival time was 20 months in A group and 22 months in B group.There was no significant differences of survival curve between two groups（P0.05）.Compared with those in B group,incidence of local infection,systemic infection,errhysis or hematoma and thrombus in catheter and the blood flow in hemodialysis using catheter were no significant difference.And there were no occurrence of fibrous sheath in both A group and B group.Conclusion Thrombus-removed operation against thrombus of cuffed catheters in jugular vein is safe and effective.