目的 比较锁骨下静脉上位置管与颈内静脉置管建立临时性血液透析 通路的优缺点。方法 采用回顾性对照研究，98例急需血液透析患者先后采 用锁骨下静脉上位置管68例，颈内静脉置管30例。观察两种插管途经的穿刺成功率、完成插管时间、导管留置时间、导管相关并发症、血流量及Kt/V值等。结果 锁骨下静脉上位穿刺成功率94.1%，显著高于颈内静脉80.0% （P＜0.01），完成插管时间亦优于颈内静脉（P＜0.05）；锁骨下静脉上位插管的 留置时间明显长于颈内静脉插管（P＜0.05），锁骨下静脉上位置管的血流量不足、感染及 导管堵塞发生率均低于颈内静脉置管（P＜0.05),两部位插管的 Kt/V值无显著性差异（P＞0.05）。结论 相对而言，锁骨下静脉上位插管是一种更理想的临时性血液通路。

objective To compare the advantages and disa d vantages of epistatic subclavian vein catheterization (ESVC) with that of internal jugular vein catheterization (IJVC) in hemodialysis. Methods Sixty-eight ESVC and 30 IJVC were performed in 98 hemodialysis patients rate of puncture success, catheterization time, the cath eters' survival life, complications, blood flow and Kt/V were observed retro spectively. Results Rate of puncture success of ESVC was significantly higher than that of IJVC(94.1% vs 80%respectively P＜0.05)and catheterization time of ESVC was shorter obviously than that of IJVC (P＜0.05); The survival life of ESVC was longer significantly than that of IJVC(P＜0.0 5) and alower incidence of infection, inadequate blood flow and obstruction were also found; Kt/V of ESVC and IJVE was of no significant difference(P＞0.05). Conclusions ESVC is relatively an ideal temporary blood access for hemodialysis.