中国血液净化

中国血液净化 ›› 2014, Vol. 13 ›› Issue (01): 41-45.doi: 10.3969/j.issn.1671-4091.2014.01.011

• 血管通路 • 上一篇    下一篇

经皮下隧道留置的带涤纶套血透用长期导管使用的影响因素分析

张晓娟1,郭华2,张沙丽1   

  1. 1. 南京解放军81医院血透室
    2. 南京军区总医院29区
  • 收稿日期:2013-08-12 修回日期:2013-09-13 出版日期:2014-01-12 发布日期:2014-01-12
  • 通讯作者: 张晓娟 juan1209@sohu.com E-mail:juan1209@sohu.com

Factors affecting long-term survival of tunneled cuffed hemodialysis catheters

  • Received:2013-08-12 Revised:2013-09-13 Online:2014-01-12 Published:2014-01-12

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摘要： 目的：前瞻性分析了既往5年内我院32例次经皮下隧道留置的带涤纶套血透用长期导管的使用寿命情况。有两种不同设计的导管参与了研究: HemoSplit (Bard), Permcath (Quinton)。方法：我们使用Kaplan-Meier单因素分析来比较不同因素对导管寿命的影响，利用Cox多元回归分析比较各影响因素的相对重要性。结果：我们发现在导管的使用寿命方面，首次置管优于重复置管；置管途径中以右颈内静脉留置导管最佳；非糖尿病患者导管使用时限较糖尿病患者长；HemoSplit 导管优于Permcath导管。患者的年龄、性别对导管使用影响不大。Cox比例风险模型发现导管的留置位置和设计似乎是影响导管使用寿命的最重要的独立影响因素。结论：临床医生在操作前应准确掌握可能影响导管使用寿命的因素并充分考虑到导管的设计方法和置入途径。

关键词: 置管, 经皮下隧道留置的静脉导管, 中央静脉, 导管使用寿命, 血液透析, 血管通路

Abstract: Objective To evaluate the factors affecting long- term survival of tunneled cuffed venous catheters (TVCs) in hemodialysis patients. Two different catheters, HemoSplit (Bard) and Permcath (Quinton) were used in this study. Methords Kaplan-Meier survival analysis with log- rank test was used to compare the effect of various factors on catheter survival. Cox regression analysis was performed to determine the relative importance of various factors. Results First, second or subsequent catheterizations had no effect on catheter survival. Age and sex also did not significantly affect catheter survival. Catheter survival was longer in right internal jugular vein indwelling catheterization and non-diabetic patients. HemoSplit catheter was better than Permcath catheter in catheter survival. Cox proportional hazard modelling demonstrated that diabetes and the vein the catheter indwells in were the independent factors for catheter survival. Conclusion Primary diseases and the vein for catheterization significantly affect catheter survival. These factors should be considered before the surgery.

Key words: Catheterization, Tunneled cuffed venous catheters, Central venous, Survival of TVCs, Hemodialysis, Vascular access