带涤纶套半永久血透导管在血液透析中的应用分析

Analyses of Application of Polyester Cuffed Semi-permanent Catheter in Hemodialysis

目的:分析和探讨带涤纶套半永久血透导管在血液透析中临床研究及应用。方法:对2011年5月-2013年5月收治的40例尿毒症患者通过建立皮下隧道及Seldinger技术留置带涤纶套血透导管进行维持性血液透析,观察其置管使用时间及并发症等情况。结果:患者带涤纶套半永久血透导管留置时间最短者4个月,最长者超过2年且至今仍在用,平均18.5个月。与临时导管比较,血流量、尿素清除指数(KT/V)方面比较差异均无统计学意义(P>0.05);但带涤纶套半永久血透导管出现感染、血栓形成、脱管等并发症情况更低、使用时间更长(P<0.05)。结论:带涤纶套半永久血透导管对于血管条件差、无法建立内瘘,尤其在条件有限基层医院的透析患者提供一条可行的长期血管通路,确保透析继续顺利进行具有重要意义。

： Objective：To analyze and investigate the clinical research and application of polyester cuffed semi-permanent dialysis catheter in hemodialysis. Method：40 cases of uremic were selected form May 2011 and May 2013 which had subcutaneous tunnel established and polyester cuffed semi-permanent dialysis catheter inserted by utilizing Seldinger technique for maintenance hemodialysis. The duration of usage of the catherter and the complications were observed. Result：The shortest stay of the polyester cuffed semi-permanent dialysis catheter was 4 months and the longest time of usage was over 2 years which was still being used. The average time of usage was about 18.5 months. Compared with the temporary catherter, both of the blood flow and urea clearance index（KT/V）had no significant difference（P〉0.05）. However,the polyester cuffed semi-permanent dialysis catheter had lower risks of infection,formation of thrombosis,detaching of catheter and other complications,and had a longer staying period（P〈0.05）. Conclusion：Polyester cuffed semi-permanent dialysis catheter provides the possibility of establishing long term access to blood vessels for patients whose blood vessels’ condition is too poor to form internal fistula,especially in the local hospitals with limited resources,which plays an important role to ensure the administration of hemodialysis.