血液透析前临时中心静脉置管117例临床分析

Clinical significance of central venous catheterization before blood dialytic therapy in 117 cases

目的探讨中心静脉留置导管在血液净化治疗中的应用,及其并发症的防治。方法回顾2009年8月至2011年1月经中心静脉置管的血透患者,其中颈内静脉置管43例,股静脉置管74例,分析不同置管方法并发症的发生率及防治方法。结果导管留置时间3～115 d,出现的并发症:出血或血肿2例(1.71%),导管相关感染7例(5.98%),导管堵塞8例(6.84%),导管滑脱1例(0.85%),血流量差39次(3.77%),两种置管方法的血流量和透析效果均满意,而颈内静脉置管归置时间长于股静脉置管。结论中心静脉置管操作简便、并发症少,能提供稳定的血流量满足透析要求,是理想的临时血液净化通路。若患者条件许可,可优先选择颈内静脉置管。

Objective To explore the significance of application of central venous catheterization in blood dialytic therapy and measures for prevention of complications.Methods The clinical data of 43 cases with internal jugular vein catheterization and 74 cases with femoral vein catheterization for hemodialysis required central venous catheter in this hospital during August 2008 to July 2010 were retrospectively reviewed and analyzed.Results The indwelling duration was 3～115 days.The complications of catheterization including oozing or hematoma in 5（4.27%） cases,catheter related infection in 10（8.55%） cases,obstruction of catheter in 8（6.84%） cases,inadequate blood flow in 39（3.77%） cases,and detachment of catheter in 2（1.71%） of cases.The blood flow and effect of hemodialysis could be satisfied with these two ways of catheterization.Conclusion Central venous catheterization is the ideal choice for setting up temporary blood access.It is simple with less complications,and it can also provide a stable blood flow for the requirement of hemodialysis.