血液净化中心静脉导管结构优化的研究进展

Research progress in optimal design of central venous catheter during blood purification

血液净化治疗已成为肾脏病患者及危重症患者不可或缺的一项救治技术。因病情需要临时实施血液净化治疗的患者,需搭建合适的血管通路以保证血液净化的顺利进行。中心静脉导管是目前最常用的临时血管通路,但目前中心静脉导管存在局部血栓、导管相关性血流感染、静脉损伤等问题,其并发症严重影响患者的血液净化治疗及预后。本文介绍了中心静脉导管结构优化设计进展,从血流动力学角度对常见中心静脉导管的再循环率、剪切力、血小板溶解系数等性能进行评估,从涂层处理和结构设计两方面提出了导管优化设计的建议,为后续中心静脉导管的改进提供参考意见。

Blood purification therapy has become an indispensable treatment technology for patients with kidney disease and critically ill patients.For patients requiring temporary blood purification treatment due to their condition,appropriate vascular access should be built to ensure the smooth progress of blood purification.Central venous catheter is commonly used for temporary vascular access at present.However,local thrombosis,catheter-related bloodstream infection,venous injury and other problems exist in the central venous catheter at present,and its complications seriously affect the blood purification treatment and prognosis of patients.We introduce the progress of structural optimization design of central venous catheters,and evaluate the recirculation rate,shear force and platelet dissolution coefficient of common central venous catheters from the perspective of hemodynamics.Some suggestions on the optimal design of the catheter are put forward from two aspects of coating treatment and structural design,which can provide reference for the improvement of the central venous catheter in the future.