牵引法在处理隧道式带涤纶套透析导管嵌顿中的应用价值

Application of traction for the treatment of stuck tunnel cuffed central venous catheters

目的总结牵引法在去除嵌顿的隧道式带涤纶套透析导管中的应用价值。方法回顾2016~2019年兰州大学第二医院就诊的隧道式带涤纶套透析导管(tunnel cuffed central venous catheter,TCC)导管嵌顿病例,使用骨科牵引装置持续固定拉力作用于导管,使管周纤维组织断裂,达到去除导管的目的。结果共纳入10例导管嵌顿患者,经持续牵引后嵌顿导管均成功去除。牵引过程中患者可进行必需的下床活动,不需完全性体位限制。所有患者在治疗中配合良好,均未发生需特殊干预的出血、心律失常、导管断裂等并发症。结论牵引法处理嵌顿导管有简单、无创、费用低、风险低、患者接受度高等优点,值得推广应用。

Objective To summarize the application of traction for removal of stuck tunnel cuffed central venous catheters.Methods The cases of incarcerated tunnel cuffed central venous catheters treated in the Second Hospital of Lanzhou University from 2016 to 2019 were retrospectively reviewed.The traction device for orthopedics was used to obtain fixed and continuous tension on the catheter to broke the fibrous tissue around the catheter and then remove the catheter.Results A total of 10 patients were enrolled.All the incarcerated catheters were successfully removed by traction.During traction,complete postural limitation was unnecessary and patients can get out of bed when required.All cases cooperated well in the treatment.No complications occurred,such as bleeding,arrhythmia and catheter rupture that required special intervention.Conclusion The traction method has the advantages of simplicity,non-invasiveness,low cost,low risk and higher patient acceptance.It is worthy of clinical use.