Permcath导管长期并发症研究

郭云珊; 李保春; 郭志勇; 付鹏; 许静; 苏红; 张国兆

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中国血液净化 ›› 2007, Vol. 6 ›› Issue (7) : 369-372.

论著

Permcath导管长期并发症研究

郭云珊李保春郭志勇付鹏许静苏红张国兆

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摘要

目的探讨长期血液透析留置双腔导管的效果和并发症，延长其使用期限。方法随访第二军医大学长海医院肾内科血液透析患者留置导管的使用情况和并发症，记录导管使用终点。结果共计106例患者，实施深静脉留置permcath导管112例次，6例次为再次置管；其中右颈内静脉置管术102例，左颈内静脉置管5例，锁骨下静脉3例，股静脉2例。导管平均使用时间为(10.6±8.9)个月，最长时间为52月。10例患者因栓塞拔管；6例患者因感染拔管；3例导管拔脱；11例患者接受肾移植；27例患者虽导管通畅，但患者因原发病等原因死亡；转入其他医院治疗及失访22例。结论深静脉留置permcath导管可长期保留，感染率低，栓塞率低，可满足透析要求，适合于用传统方法无法建立长期透析通路的患者和准备近期行肾移植的患者。

Abstract

Objective To evaluate the value and complications of long-term indwelling Permcath catheter as blood access for hemodialysis. Methods Permcath catheters for long-term blood access were implanted in 106 chronic renal failure patients. Survival and complications of these catheterized patients were followed-up and recorded. Results Indwelling Permcath catheters were performed in 106 patients, of which 6 cases required to be re-implanted the catheter. Catheters were held in right internal jugular vein in 102 cases, left internal jugular vein in 5 cases, right subclavian vein in 3 cases and femoral vein in 2 cases. The average indwelling time of the catheter was (10.6+8.9)months, and the longest lasted for 52 months. Failure of the catheterization was caused by thrombosis formation (10/106), infections (6/106) or insecure of the catheter (3/106). Twenty-seven patients died of uremia complications with normal function of their catheters, and 11 patients received renal transplantation. Conclusion Permcath catheter can be indwelled in veins for hemodialyis access for a long time with a relatively low rate of infection and thrombosis formation. It is suitable for those whose routine vascular access is unavailable and those who are going to receive renal transplantation.