人工肝血液净化患者中心静脉导管留置时间的研究

I ndwelling time of central venous catheter in patients with artificial liver blood purification

目的探讨肝衰竭患者进行人工肝血液净化治疗留置中心静脉导管的最佳时间。方法选择进行人工肝血液净化治疗留置中心静脉导管的190例肝衰竭患者,其中男性163例,女性27例;年龄13-81岁,平均年龄47.7岁。按中心静脉导管留置时间分为5组,即1-7 d组、8-14 d组、15-21 d组、22-28 d组、大于28 d组。观察中心静脉导管留置期间不良反应发生情况。结果相关并发症发生率留置1-7 d组46例患者,不良反应11例,不良反应率为23.9%;8-14 d组56例患者,不良反应19例,不良反应率为33.9%;15-21 d组25例患者,不良反应11例,不良反应率为44.0%;22-28 d组41例患者,不良反应18例,不良反应率为43.9%;大于28 d组22例患者,不良反应12例,不良反应率为54.5%。渗血不良反应的发生各组间无差异。结论肝衰竭患者进行人工肝血液净化治疗时,留置中心静脉导管相关并发症的发生与留置时间相关,随着留置时间的延长并发症呈增加趋势,留管时间一般不应超过14 d,是否延长留置时间取决于临床工作中患者实际情况。渗血不良反应的发生与留置时间无关。

Objective To study the best indwelling time of central venous catheter in patients with artificial liver blood purification.Methods A total of 190 patients with indwelling central venous catheter during artificial liver blood purification were enrolled,which included 163 males and 27 females, aged 13- 81 years old with mean age of 47.7 years old. All of them were divided into 5groups based on central venous catheter indwelling time, 1- 7 days group, 8- 14 days group, 15- 21 days group, 22- 28 days group and over 28 days group. The adverse reactions of central venous catheters were observed. Results Incidence rate of related complications during indwelling time was 23.9 %, 33.9 %, 44.0 %, 43.9 % and 54.5 % in 1- 7 days group, 8- 14 days group, 15- 21 days group, 22- 28 days group and over 28 days group, respectively. The adverse reactions bleeding was no difference between each groups. Conclusion It is demonstrated that in patients with artificial liver blood purification, occurrence rate of complication increased with central venous catheter indwelling time, which generally should be less than 14 days, and indwelling time depends on practical situation of patients in clinical. The occurrence rate of adverse reactions bleeding is no related to indwelling time.