股静脉穿刺留置双腔导管联合抗生素封管在血液净化中临床应用

SEALING EFFECTS OF FEMORAL INTRAVENOUS INDWELLING CATHETER SYSTEM COMBINED WITH ANTIBIOTIC ON BLOOD PURIFICATION

目的股静脉穿刺置管在血液净化中的应用价值。方法对374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。结果一次性成功率达96.8%(362例),96.0%(359例)患者血流量能达到200ml/min以上,误穿动脉导致局部血肿发生24例,局部按压45min自行吸收;局部渗血11例,局部压迫后止血。导管相关感染,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。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。可适用于急性肾衰、手臂内瘘成熟前需要过渡通路血液透析治疗的患者。

Objective To explore sealing effects of femoral intravenous indwelling catheter system combined with antibiotic on blood purification.Methods Success rate and complications of 374 cases with femoral intravenous indwelling catheter system were analyze.Results One-time success rate was 96.8%（362 patients）,blood flow on 96.0% of patients（359 patients） could reach 200 ml/min or more.24 cases were errors occur through arteries leading to localized hematoma,it was self-absorbed with the local press for 45 minutes.11 cases with local bleeding were taken by partial compression haemostasis.The use of heparin mixed saline plus antibiotics could eliminate symptoms of catheter-related infection.Venous catheter thrombosis could thrombolytic treat with urokinase.Conclusions Femoral intravenous indwelling catheter system is an ideal temporary vascular access with a higher success rate and few complications.It is applicable to acute renal failure,chronic renal failure,pre-arm fistula maturation,food and drug poisoning and other blood dialysis.