中国血液净化

中国血液净化 ›› 2016, Vol. 15 ›› Issue (03): 176-179.doi: 10.3969/j.issn.1671-4091.2016.03.013

• 血管通路 • 上一篇    下一篇

关于中心静脉导管封管液漏出率的体外研究

吝泽华1,李红霞2,连立超1,李松1,杨冰1,左力1   

  1. 1. 北京大学人民医院肾内科
    2. 北京大学人民医院检验科
  • 收稿日期:2015-12-02 修回日期:2016-01-13 出版日期:2016-03-12 发布日期:2016-03-19
  • 通讯作者: 杨冰 yangbingqf@163.com E-mail:ZuoLiMD@Hotmail.com
  • 基金资助:

    中国医院协会血液净化中心管理分会研究项目（CHABP201622），项目编号：2015-Z-26

An in vitro study about the leakage of catheter locking solution from central venous catheter

  • Received:2015-12-02 Revised:2016-01-13 Online:2016-03-12 Published:2016-03-19

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摘要： 目的观察维持性血液透析患者使用的中心静脉导管给予封管液封管后1min 到96h 的封管液漏出情况。方法中心静脉导管提前进行处理，侧孔保持水平。中心静脉导管充满蒸馏水，尖端置于盛有100ml 蒸馏水的烧杯内。向导管动脉端注入等标量容积的封管液(50%葡萄糖)，根据不同时间烧杯内葡萄糖浓度计算出不同时间导管的漏出率，此过程重复15 次，计算出平均漏出率。结果封管后，1min 漏出率为26.6%～46.0%，2h 漏出率39.2%～67.2%，24h 漏出率56.5%～71.5%，48h 漏出率63.7%～82.1%，96h 漏出率高达71.4%～87.9%。导管封管液存在早期的快速漏出和后期的持续缓慢漏出。结论封管后导管内有大量封管液进入烧杯内；推测在体内，肝素封管后，有大量肝素进入体内，进而对凝血过程造成影响；应当根据患者实际情况个体化封管液的肝素浓度。

关键词: 中心静脉导管, 封管液, 漏出率

Abstract: Objective To observe the in vitro leakage of catheter lock solution from the clinically used central venous catheters after lock with the solution for 1 min to 96 hrs. Methods The side holes of the catheter were horizontally placed in advance. The catheter was flushed and locked with distilled water. The tip of the catheter was placed in a beaker containing 100ml distilled water. The volume of lock solution (50% dextrose solution) injected into the catheter (artery access) equaled the catheter nominal capacity. The leak ratio was calculated from the concentration of dextrose in the beaker. The experiment was repeated for 15 times, and the average data were then calculated. Results After injection of lock solution into the artery access, the leak ratio was 26.6%～46.0% after 1min, 39.2%～67.2% after 2 hrs, 56.5%～71.5% after 24 hrs, 63.7%～ 82.1% after 48 hrs, and 71.4%～87.9% after 96 hrs. Hence, there were a rapid early leak and a slower later
leak of the lock solution. Conclusion After injection of the lock solution a large quantity of lock solution leaked into the beaker, indicating that a great deal of lock solution may infiltrate into body circulation and interfere with blood coagulation. Therefore, heparin concentration in lock solution should be individualized based on clinical status of the patients.

Key words: Central venous catheter, leak ratio, lock solution