中国血液净化

中国血液净化 ›› 2019, Vol. 18 ›› Issue (01): 57-59.doi: 10.3969/j.issn.1671-4091.2019.01.013

• 血管通路 • 上一篇    下一篇

无切口水囊扩张法拔除血液透析用带Cuff带隧道导管的临床应用

许焱1,刘凤华1,史振伟1   

  1. 1.  煤炭总医院肾内科
  • 收稿日期:2018-04-10 修回日期:2018-11-05 出版日期:2019-01-12 发布日期:2018-12-25
  • 通讯作者: 史振伟 shizhenwei2008@126.com E-mail:shizhenwei2008@126.com

Clinical application of the water balloon expansion without incision method to remove the cuff and tunneled catheters in hemodialysis patients

  • Received:2018-04-10 Revised:2018-11-05 Online:2019-01-12 Published:2018-12-25

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摘要： 【摘要】目的探讨总结无切口水囊扩张血液透析用隧道导管拔除法的方法、并发症和效果。方法2015 年1 月～2017 年12 月煤炭总医院肾内科应用无切口水囊扩张法(水囊组)拔除血液透析带Cuff 带隧道导管34 例，传统开放式(传统组)切开拔除血液透析带Cuff 带隧道导管24 例，均符合带Cuff 带隧道中心静脉留置导管拔除指证。结果2 组患者在性别、年龄构成和导管留置时间上差异无统计学意义(P 值分别为0.897,0.690,0.689)。传统方法拔管组24 例患者平均手术时间(20.63±7.05)min，术中出血量约为(10.18±4.16)ml；水囊扩张拔管组34 例患者平均手术时间(5.44±2.65)min，术中出血量平均(4.04±2.46)ml，2 组间2 项观察指标均有统计学意义(P 值分别为＜0.001,＜0.001)，术后渗血及血肿发生率传统组为12.5%(3/24)，水囊组为2.94%(1/34)。感染并发症未发生，2 组间无统计学差异。结论无切口水囊扩张法拔除血液透析带Cuff 带隧道导管具有降低手术难度，缩短手术时间，降低术中出血量等优点，安全有效。

关键词: 隧道涤纶套血液透析导管, 血液透析, 尿毒症

Abstract: 【Abstract】Objective To explore the methods, complications and effects of the water balloon expansion without incision method to remove the cuff and tunneled catheters in hemodialysis patients. Methods During the period between Jan. 2015 and Dec. 2015, 34 hemodialysis patients used the water balloon expansion without incision method (WG group) and 24 hemodialysis patients used the traditional open surgery (TG group) to remove the central vein cuff and tunneled catheters which had the indication to be removed. Results There were no statistically significant differences in gender, age and catheter retention time between the two groups (P=0.897, 0.690 and 0.689 respectively; P＞0.05). In TG group, the average operation time was 20.63±7.05 minutes with blood loss of 10.18±4.16 ml; in WG group, the average operation time was 5.44±2.65min with blood loss of 4.04±2.46 ml (P=0.0001 and 0.0001 respectively). Blood leakage and hematoma rate was 2.94% (1/34) in WG group and 12.5% (3/24) in TG group (P=0.374). No infection occurred within two weeks after operation. Conclusion The water balloon expansion without incision method is effective to resolve the difficulties of catheter removal with less operation time and intra-operative bleeding.

Key words: cuff and tunneled hemodialysis catheter, hemodialysis, uremia