2 206例中心静脉置管在血液透析中的应用

Application of 2 206 cases of central venous catheter in hemodialysis

目的 探讨中心静脉置管（CVT）在血液透析中的应用.方法 回顾性分析2 206例CVT患者的临床资料,观察导管穿刺部位、导管留置时间、4周血流通畅率、导管相关性感染发生率等.结果 颈内静脉留置2 033例,股静脉留置173例.颈内静脉导管留置时间为（40.6±32.7）d,股静脉导管留置时间为（22.4± 16.3）d,二者差异有统计学意义（P＜0.05）.颈内静脉留置导管4周血流通畅率96.4％（1 959/2 033）,明显高于股静脉的83.2％（144/173）,差异有统计学意义（P＜0.05）.股静脉导管相关性感染发生率为11.0％（19/173）,显著高于颈内静脉的3.6％（73/2 033）,差异有统计学意义（P＜0.05）.结论 应用CVT行血液透析便捷可靠,感染率低,并发症较少,操作技术水平是成功的关键.

Objective To explore the application of central venous catheter（CVT） in hemodialysis.Methods The clinical data of 2 206 cases of CVT patients were analyzed retrospectively,and the catheter puncture site,the catheter indwelling time,4 weeks of blood flow rate and the incidence of catheter related infections,and so on were observed.Results Internal jugular vein in 2 033 cases,the femoral vein in 173 cases.Internal jugular vein indwelling catheter time was （40.6 ±32.7） d,the femoral vein catheter indwelling time was （22.4 ± 16.3） d,and the difference was statistically significant （P＜ 0.05）.Blood flow patency rate in four weeks was of 96.4％ （1 959/2 033） indwelling catheter in internal jugular vein,which was significantly higher than that of the femoral vein in 83.2％ （144/173）,and the difference was statistically significant （P ＜ 0.05）.Femoral vein catheter related infection rate was 11.0％ （19/173）,significantly higher than that of internal jugular vein in 3.6％ （73/2 033）,the difference was statistically significant （P ＜ 0.05）.Conclusion Application of CVT for hemodialysis is convenient and reliable,with low infection rate,fewer complications,operation technology level is the key to success.