中国血液净化

中国血液净化 ›› 2019, Vol. 18 ›› Issue (04): 270-272.doi: 10.3969/j.issn.1671-4091.2019.04.016

• 血管通路 • 上一篇    下一篇

血液透析用颈内静脉临时插管专用固定装置的设计及临床应用

李克佳1,王欢1,汤莉琴1,付月亿1   

  1. 1.航天中心医院肾内科
  • 收稿日期:2018-09-03 修回日期:2019-01-28 出版日期:2019-04-12 发布日期:2019-04-12
  • 通讯作者: 李克佳angelakejia@126.com E-mail:angelakejia@126.com

Design and clinical application of the fixation device for temporary internal jugular vein catheter in hemodialysis

  • Received:2018-09-03 Revised:2019-01-28 Online:2019-04-12 Published:2019-04-12

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摘要： 【摘要】目的探讨自制专用固定装置在血液透析用颈内静脉临时插管固定中的应用效果。方法对110 例在航天中心医院行颈内静脉置入临时双腔血液透析导管的患者，对照组采用常规纱布包裹、普通透明胶布粘贴的方法，观察组采用专用固定装置。2 周后评价导管滑脱发生率、固定导管周围皮肤整洁度、医用胶粘相关性皮肤损伤情况、患者舒适性、固定的稳定性、患者对导管固定的满意度，进行效果比较。结果观察组导管周围皮肤的清洁度优于对照组(χ２=8.419,P=0.004)；患者舒适性优于对照组(χ２=4.583,P=0.032)；导管固定的稳定性观察组优于对照组(χ２=9.340,P=0.002)，差异有统计学意义；观察组导管固定处的医用黏胶相关性皮肤损伤发生率也低于对照组，差异有统计学意义(χ２=5.986，P=0.014)。观察组患者对导管固定的满意度高于对照组，差异有统计学意义(t=-4.763，P＜0.001)。观察组导管滑脱发生率低于对照组，但差异无统计学意义(χ２=0.259，P=0.611)。结论使用专用固定装置固定颈内静脉临时血液透析导管的方法可提高患者舒适性、固定稳定性、周围皮肤清洁度，降低导管感染发生率和医用黏胶的皮肤损害，患者满意度高，适合临床使用。

关键词: 颈内静脉导管, 血液透析, 固定装置

Abstract: 【Abstract】Objective To investigate the effect of a fixation device for temporary internal jugular vein catheter in hemodialysis. Methods A total of 110 patients with temporary dual-chamber internal jugular venous catheter for hemodialysis in Aero Space Center Hospital were enrolled in this study. In the control group, the catheter was wrapped with conventional gauze and pasted with ordinary transparent adhesive tape; in the observation group, the catheter was fixed with a special device. After 2 weeks, the incidence of catheter slip, skin cleanliness around the fixed catheter, medical adhesive-related skin injury (MARSI), comfort of patients, stability of the fixed catheter, and satisfaction of patients with the catheter fixation were evaluated and compared. Results The cleanliness of the skin around the catheter was better in the observation group than in the control group (χ ２=8.419,P=0.004); the comfort of the patients was better in the observation group than in the control group (χ２=4.583,P=0.032); the stability of catheter fixation was better in the observation group than in the control group (χ ２=9.340, P=0.002);the incidence of MARSI was lower in the observation group than in the control group (χ２=5.986, P=0.014). Patients satisfied with the catheter fixation were more in the observation group than in the control group (t=-4.763,P＜0.001). The incidence of catheter slip was lower in the observation group than in the control group, but the difference was not statistically significant (χ ２ =0.259,P=0.611). Conclusion The specific fixation device for temporary internal jugular vein catheter in hemodialysis can improve patients’comfort, fixation stability and peripheral skin cleanliness and reduce the incidence of catheter infection and MARSI with higher satisfication from the patients. This device is suitable for clinical use.

Key words: Internal jugular vein catheter, Hemodialysis, Fixation device