中国血液净化

中国血液净化 ›› 2018, Vol. 17 ›› Issue (12): 843-846.doi: 10.3969/j.issn.1671-4091.2018.12.013

• 血管通路 • 上一篇    下一篇

弯折角度是临时性血液透析导管功能不良的重要因素

陈小玲1,包崑2,梁子安1,禤晓燕1   

  1. 1. 暨南大学附属江门中医院肾内科
    2. 广州中医药大学第二附属医院广东省中医院大学城医院肾内科
  • 收稿日期:2018-06-25 修回日期:2018-09-09 出版日期:2018-12-12 发布日期:2018-12-19
  • 通讯作者: 包崑 baokun1719@yahoo.com.cn E-mail:baokun1719@yahoo.com.cn

Bending-angle is an important factor for the dysfunction of temporary hemodialysis catheters

  • Received:2018-06-25 Revised:2018-09-09 Online:2018-12-12 Published:2018-12-19

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摘要： 【摘要】目的通过观察维持性血液透析患者拔除的临时性导管的外观和纵切面情况分析导管功能不良的原因。方法选取2017 年1 月～2018 年6 月暨南大学附属江门中医院肾内科使用临时性导管开始维持性血液透析，后同在此地拔除导管的患者进行观察。通过观察该类患者的导管的主干段弯折角度、纤维蛋白鞘形成情况、纵切面的血栓长度，结合其他情况，分析临时性导管功能不良的原因。结果共有45 例患者。导管功能不良率为13.33%(6/45)。导管弯折角度为5°～44°，导管功能正常组和不良组弯折角度均值分别为(13.87 ± 5.42)°、(31.67 ± 7.71)°，两组差异有统计学意义 (t = -5.449, P = 0.002)。血流量与年龄及弯折角度成负相关关系(r= 0.811, P＜0.001)。静脉血栓长度与年龄及弯折角度成负相关关系(r=0.722，P＜0.001)。结论临时性导管的弯折角度是血液透析患者导管功能不良的重要因素，弯折角度越大，导管功能越差；当角度＞30°时将明显增加导管功能不良的可能性。

关键词: 临时性导管, 导管功能不良, 血液透析

Abstract: 【Abstract】Objective To analyze the causes of catheter dysfunction by observation of the appearance and longitudinal section of the temporary catheters removed from maintaining hemodialysis (MHD) patients. Methods The MHD patients using temporary catheters at the beginning of MHD in Department of Nephrology, Jiangmen Traditional Chinese Medicine Hospital Affiliated to Jinan University from January 2017 to June 2018 were recruited for analyses. We analyzed the cause of catheter dysfunction by observation of the removed temporary catheters about the bending-angle of the main segment, the formation of fibrin sheath and the length of thrombus in the longitudinal section of the catheters. Results A total of 45 patients were available for analyses. The rate of catheter dysfunction was 13.33% (6/45). The bending- angle of the catheter ranged from 5°～44°. The mean bending-angles of the functional catheter group and the dysfunctional catheter group were 13.87±5.42° and 31.67±7.71° respectively (t=-5.449, P=0.002). Blood flow was negatively correlated with age and bending-angle (t=10.027, P＜0.001). The length of venous thrombus was negatively correlated with age and bending-angle (r=0.722, P＜0.001). Conclusion The bending-angle of temporary catheter is an important factor for catheter dysfunction in MHD patients. The larger the bending-angle was, the worse the catheter function was. When the angle is greater than 30 degrees, the possibility of catheter dysfunction increase significantly.

Key words: Temporary catheterr, Catheter dysfunction, Hemodialysis