中国血液净化

中国血液净化 ›› 2019, Vol. 18 ›› Issue (08): 564-567.doi: 10.3969/j.issn.1671-4091.2019.08.014

• 血管通路 • 上一篇    下一篇

关于中心静脉导管封管液残存率的体外研究

张国胜1.2,焦夏1.3,吝泽华4,左力1   

  1. 1 北京大学人民医院肾内科
    2 河南中医药大学附属郑州市中医院肾内科
    3 运城同德医院肾内科
    4 北京博爱医院肾内科
  • 收稿日期:2019-01-07 修回日期:2019-05-28 出版日期:2019-08-12 发布日期:2019-08-15
  • 通讯作者: 左力 zuoli@bjmu.edu.cn

An in vitro study about the remaining rate of sealing fluid in central venous catheters

  1. 1Department of Nephrology, Peking University People’s Hospital, Beijing 100044, China
    2Department of Nephrology, Zhengzhou Traditional Chinese Medicine Hospital Affiliated to Henan University of Traditional Chinese Medicine, Zhengzhou 150007, China
    3Department of Nephrology, Yuncheng Tongde Hospital, Yuncheng 044000, China
    4Department of Nephrology, Beijing Boai Hospital, Beijing 100068, China
  • Received:2019-01-07 Revised:2019-05-28 Online:2019-08-12 Published:2019-08-15

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摘要：

【摘要】目的观察中心静脉导管0～96h 封管液时间分段梯度浓度，总结封管液的浓度-时间的变化规律。方法导管垂直置于1000ml 二级反渗水的烧瓶内，向导管静脉端注入等标量容积的封管液。从导管尖端到尾部依次分为6 段留取标本，此过程重复10 次。计算出平均浓度，描绘出浓度-时间曲线图，进行4 参数模型曲线拟合求出参数。结果封管后即刻，导管尖段残存浓度为(15.8±0.8) mmol/L，5min 时快速下降到(9.9±0.9)mmol/L，然后缓慢下降到96h 的(0.7±0.1)mmol/L；第2 段的残存浓度从即刻的(22.4 ± 0.6) mmol/L 逐渐下降到96h 的(2.7±0.4)mmol/L；第1 至第6 段下降速度依次变慢，96h 时第4、5 和6 段残存浓度相似。拟合方程Y=(A-D)/[1+(T/C)B]+D 能啮合药时曲线图(R2＞90)。结论封管后即刻管尖端封管液即已流失，在5min 内快速流失，封管液浓度明显下降。可根据拟合方程推算出临床上合适的封管液浓度和有效作用时间从而制定合理的封管策略。

关键词: 中心静脉导管, 封管液, 残存率

Abstract: 【Abstract】Objective To observe the gradient concentration of sealing fluid sealed in central vein catheters for 0-96 hours, and to summarize the concentration-time changing rule of the sealing fluid. Methods A catheters was placed vertically in a flask containing 1,000ml reverse-osmosis water of secondary grade. The scaled volume of sealing fluid was injected into the venous end of the catheter. Samples were collected from tip to tail of the catheter in six parts, and the procedure was repeated 10 times. The average concentration was calculated, the concentration-time curve was drawn, and the parameters were obtained by fitting the four-parameter model curve. Results Immediately after tube closure, the concentration remained in the tip segment was 15.8 ± 0.8mmol/L, rapidly decreased to 9.9 ± 0.9mmol/L in 5 minutes, then slowly decreased to 0.7 ±0.1mmol/L after 96 hours. The concentration remained in the second segment gradually decreased from 22.4±0.6mmol/L immediately after tube closure to 2.7±0.4mmol/L after 96 hours. The decline rate slowed down along the first to sixth segments. The concentration of remained sealing fluid was similar in the fourth, fifth and sixth segments after 96 hours. Fitting equation Y=(A- D)/[1 + (T/C)B] +D can mesh with the propellant curve (R2＞90). Conclusion Immediately after sealing, the sealing fluid at the tip of the tube lost and quickly and further lost within 5 minutes, associated with significant decrease of sealing fluid concentration. According
to the fitting equation, the suitable concentration and effective time of sealing fluid can be calculated and a reasonable sealing strategy can be worked out.

Key words: Central venous catheter, Sealing fluid, Remaining rate

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