深静脉置管在血液透析患者中的运用

The application of deep vein catheterization in hemodialysis patients

目的评价深静脉留置导管作为血液透析通路的效果。方法采用Seldinger技术穿刺深静脉,将留置导管送入血管。结果共计72例患者,其中颈内静脉27例,锁骨下静脉2例,股静脉43例。2例患者因感染无法控制而拔管并放弃治疗,1例置管栓塞改腹膜透析,58例患者应用置管透析直到其它血管通路的建立,其余11例继续应用至今。结论深静脉导管使用时间较长,在短期内栓塞率、感染率低,可满足血液透析要求,值得推广应用。

Objective To evaluate the effect of deep vein catheterization as hemodialysis access. Methods Catheterization was performed in patients by the Seldinger technique,that a guidewire was inserted into a deep vein. Results Among the 72 cases with deep vein catheterization, catheters in 27 cases were inserted through internal jugular veins, 2 cases through subclavian veins, 43 cases through femoral veins. Catheterization was terminated in 2 cases due to uncontrollable infections, 1 case used peritoneal dialysis instead because of catheter embolization,58 cases indwelling dialysis to other vascular access established,the remaining 11 patients were still under catheterization by the end of the study. Conclusion Deep vein catheterization has long effective duration and low rate of embolism and infection.It can meet the relative needs for hemodialysis, therefore it should be extensively applied as a hemodialysis access.