长期留置中心静脉导管在血液透析患者中的临床应用研究

Research on Clinical Application of the Tunneled Cuffed Catheter in Hemodialysis

目的：观察长期留置中心静脉导管（TCC）在血液透析中的可行性。方法：30例无法建立血管内瘘的患者，采用Permcath双腔导管作右侧颈内静脉内置入。结果：30例均一次性置管成功，期间发生血栓形成或血流不畅2例，感染2例，出血2例，经处理后消失。除4例死亡外（非导管因素），其余均在继续透析中，血流量在200~300 mL/min之间。透析充分性与动静脉内瘘（AVF）患者比较差异无统计学意义（P〉0.05）。结论：TCC长期导管安全性能高，能满足临床透析需要，为维持性透析患者建立血管通路的极好补充形式。

Objective：To observe the feasibility of the clinical application the tunneled cuffed catheter（TCC）in hemodialysis. Method：Thirty patients who cannot be established endovascular fistula were adopted in Permcath dual cavity catheter which was put in the right internal jugular vein. Result：Thirty cases were all succeeded in catheter,and thrombosis or poor blood flow occurred in 2 cases,infection in 2 cases,hemorrhaged in 2 cases, which disappeared after the treatment. Except 4 cases died（Not-TCC factors）,the rest were on dialysis,whose blood flowed from 200 to 300 mL/min. There was no difference between TCC and Arteriovenous fistula（AVF）in dialysis adequacy（P〉0.05）. Conclusion：TCC is safe enough to meet the clinical dialysis,which is an optimal and alternative vascular access for maintenance patients in hemodialysis.