带涤纶套隧道双腔深静脉导管为血液透析通路的临床研究

Clinical Study on the Use of Silicone Dual-lumen Catheter with a Dacron Cuff as Hemodialysis Access

目的:探讨以带涤纶套隧道双腔静脉导管(TCC)为血管通路患者的透析充分性及并发症。方法:选择我院45例血液透析患者,其中带涤纶套隧道双腔深静脉置管患者22例,动静脉内瘘患者23例,观察完成透析患者透析充分性指标以及并发症发生情况并进行分析比较。结果:带涤纶套隧道双腔深静脉置管患者与动静脉内瘘患者比较,尿毒清除指数(KT/V)、尿素降低率(URR)及蛋白质分解代谢率(PCR)无显著差异。带涤纶套隧道双腔深静脉置管患者血流不畅、血栓栓塞及感染发生率高于动静脉内瘘患者(P【0.05),而出血发生率低于动静脉内瘘患者(P【0.05)。结论:带涤纶套隧道双腔深静脉导管为通路是血液透析比较理想的血管通路,是一种有效的安全的替代方式,只要采取有效的预防护理措施,降低并发症的发生率,导管的使用寿命可以明显延长。

Objective:To investigate dialysis adequacy and complications associated with hemodialysis with silicone dual-lumewn catheter with a dacron cuff as access.Method:45 hemodialysis patients treated in our hospital were chosen as testees,among whom 22 used silicone dual-lumewn catheter with a dacron cuff and the other 23 used arteriovenous fistula.Observe the the dialysis adequacy index and the complication conditions of the hemodialysis patients in the two groups of testee and make comparison and analysis.Results:No significant difference was found in KT/V,URR,PCR between the two groups.The frequency of unsmooth flow of blood,thromboembolism and infection incidence rate in patients with silicone dual-lumewn catheter with a dacron cuff was higher than those in patients with arteriovenous fistula(P<0.05),while the frequecy of bleeding was lower(P<0.05).Conclusion:Silicon dual-lumewn catheter with a dacron cuff is an ideal vascular access for hemodialysis patients.For the patients in whose body the arteriovenous fistula is hard to built,especially for those whose cardio-pulmonary function or vascular condition is poor,silicon dual-lumewn catheter with a dacron cuff is safe alternative.If effective measures are taken,the service life of catheter can be significantly prolonged.