改良钢丝引导留置永久性颈内静脉导管的临床应用

Clinical application of permanent jugular venous catheter indwelling for hemodialysis under modified steel-wire guidance

目的:探讨改良钢丝引导法留置血液透析用永久性颈内静脉导管较常规撕脱鞘置管法的优越性。方法:对80例终末期肾病(ESRD)患者行带涤纶套永久性颈内静脉导管手术,其中42例采用改良钢丝引导法(改良组),38例采用传统撕脱型扩张导管置管法(常规组),比较2组出血量、并发症、成功率及疗效。结果:改良组较常规组成功率高且手术出血量少(P<0.05),但kt/v值比较无明显差异(P>0.05)。结论:改良钢丝引导法留置永久性颈内静脉导管与常规法比较,透析效果相似,且出血量少,并发症少,成功率高,操作简单,值得临床推广应用。

Objective：To explore the superiority of indwelling permanent jugular venous catheters for hemodialysis under modified steel-wire guidance through compared with the conventional avulsion technique. Methods：Eighty patients with end stage renal disease （ESRD） accepting permanent jugular venous catheter indwelling were randomly allocated into two groups ：42 patients were performed under modified steel-wire guidance （modified group） while 38 patients applied conventional Seldinger technique （ conventional group）. The bleeding volume, complications, success rate and therapeutic effect were compared in two groups. Results：The success rate was higher and bleeding volume was less in modified group compared with those of conventional group （P 〈0. 05） ,but there was no significant difference in kt/v between these two groups （P 〉 0.05）. Conclusions：Compared with the conventional technique, the modified way of indwelling permanent jugular venous catheter under steel-wire guidance has such advantages as minor bleeding, high success rate and can be performed simply and easily. It is worth further clinical application.