关键词: 血液透析, 深静脉置管术, 不利因素, 并发症

Abstract: 【Abstract】Objective The present study aimed to summarize the clinical experience about management of central venous catheterization (CVC) associated complications in order to reduce the severe complications. Methods Information about all CVC patients treated in the Hemodialysis Department of Guangdong Provincial Hospital of Chinese Medicine during 2015-2016 in the dataset was analyzed. The information included demographic characteristics, clinical features, unfavorable factors, complications and the outcome of CVC. The unfavorable factors and complications were investigated. Results Totally there were 277 cases having CVC operation. Of them, the operation was unsuccessful at one time in 72 patients (25.99%). The unfavorable factors during the operation included obstruction of guide wire insertion, venous collapse, nervousness of the patient and hematoma. Complications during the operation occurred in 40 cases (14.44%), including puncture of artery, hematoma formation, bleeding at puncture site and misplacement of catheter. All CVCs were successfully operated after appropriate adjustment. In the 3 cases of catheter misplacement, we took the advantages of other examinations and interdisciplinary cooperation to adjust the position of catheters or to establish a new catheterization. Conclusion Obstruction of guide wire insertion, venous collapse, nervousness of the patient and hematoma are unfavorable factors during CVC operation. These should be recognized promptly to prevent associated complications. In case of CVC with complications, X-ray and ultrasonic examinations as well as multidisciplinary consultations are of great helpful to avoid severe adverse events.

Key words: Hemodialysis, central venous catheterization, Unfavorable factor, Complications