右侧颈部前路和中路植入带涤纶套中心静脉导管的对比研究

Comparative Study on Cuffed Central Venous Catheter Inserted by Right Neck Anterior and Middle Approaches

目的对比分析右侧颈部前路和中路植入带涤纶套中心静脉导管的临床应用价值。方法回顾性分析2004年7月—2012年6月于我科行右侧颈部植入带涤纶套中心静脉导管患者42例。其中从右侧颈部前路植入的患者20例为A组,从右侧颈部中路植入的患者22例为B组,观察对比两组导管的相关并发症(局部出血、血肿;导管感染;导管堵塞)、透析中血流量及透析spKt/V值的影响。结果两组的局部出血/血肿、导管感染、导管堵管比较,差异均无统计学意义(P>0.05);A组的spKt/V值、血流量均低于B组,差异有统计学意义(P<0.01)。结论从右侧颈部中路植入带涤纶套中心静脉导管在透析中有较高的透析血流量及spKt/V值,值得临床上推广应用。

Objective To compare the clinical value of cuffed central venous catheter inserted by right neck anterior and middle approaches. Methods A total of 42 cases inserted with cuffed central venous catheter by fight neck in our department between July 2004 and June 2012 were retrospectively analyzed. Related complications （local bleeding/hematoma, catheter infection, and catheter blockage）, blood flow and spKt/V during dialysis were compared between the anterior approach group （ n = 20） and middle approach group （ n = 22）. Results No significant difference was observed between the two groups in local bleeding/hematoma, catheter infection, and catheter blockage （ P 〉 0. 05 ）. The blood flow and spKt/V of the anterior approach group were lower than that of the middle approach group （P 〈 0. 01 ）. Conclusion Cuffed central venous catheter inserted by fight neck middle approach is more effective and worthy of extensive clinical application.