X线透视下留置双腔Cuff导管建立血透通路的初步探讨

The Establishment of Hemodialysis Pathway via Indwelling Dual-lumen Catheter with Cuff under Fluoroscopy

目的探讨X线透视下留置双腔Cuff导管建立血透通路方法的可行性及优势。方法回顾性分析21例经颈内静脉留置双腔Cuff导管患者的临床资料。结果本组21例均透视下成功留置双腔Cuff导管，成功率100％。置管后隧道出血2例，经压迫均止血；隧道口感染2例，局部加强换药，并口服抗生素治愈。无一例发生气胸、血胸、空气栓塞、静脉撕裂等严重并发症。随访19例，导管使用时间为2—25个月。结论X线透视下操作结合术前彩超评估血管情况及体表定位，可使留置双腔Cuff导管更安全。

Objective To discuss the feasibility and safety of indwelling dual-lumen catheter with cuff under fluoroscopy to establish the hemodialysis pathway. Methods The clinical data of 21 cases indwelled dual-lumen catheter with cuff through jugular under fluoroscopy were retrospectively reviewed. The method of central venous catheter insertion, postoperative complications and catheter usage were analyzed. Results All 21 cases were accomplished the catheterization successfully with the rate of 100%. Two cases were found tunnel bleeding and stopped by compression; two cases were tunnel portal infection and cured by change dressing and oral antibiotic treatment. No serious complication such as pneumothorax, hemothorax, air embolism and vein dilacerations were found. Conclusion Preoperative color Doppler assessment of blood vessels and surface positioning and operation under fluoroscopy can make the retention of dialysis catheters safer for haemodialysis.