关键词: 血液透析, 透析通路, 带涤纶环导管

Abstract:

Objective To evaluate the effects of cuffed catheter as the permanent hemodialysis access. Methods The standard Seldinger technique was used for guidewire insertion in the central vein. The tunnel was designed according to the transfer signs of the vein. In choosing the catheter exit site, it was also important to keep in mind that the final subcutaneous position of the catheter would take on a gentle bend to avoid any kinking of the catheter. Using a standard tunneling device, the cuffed catheter was pulled through subcutaneously up to the entrance of the guidewire, until the Dacron cuff of the catheter was placed subcutaneously at least 1.0 cm beyond the exit site. Soft and hard dilator was then placed over the guidewire and the cuffed catheter was then inserted through the peel-away sheath. Results The operation were performed in 65 patients. Among them, 59 patients were inserted through right internal jugular veins, 8 patients through right subclavian veins and 2 patients through femoral veins. The average using time were (6.3±4.2) months, the longest time were 38 months. The catheter functions were lost due to thrombosis (21/65)and infection (8/65). There were 14 patients died of uremia complications and 4 patients received renal transplantation with normal catheter function. Twelve patients were still using the cuffed catheters at the end of the investigation. Conclusion The cuffed catheter hemodialysis access can be kept for using for a relative long time with low rate of infection and thrombosis and is a good choice for the patients who can not use the traditional method to set up vascular access and the patients who prepare to receive renal transplantation.

Key words: Hemodialysis access, Cuffed catheter