中国血液净化

中国血液净化 ›› 2013, Vol. 12 ›› Issue (11): 594-597.doi: 10.3969/j.issn.1671-4091.2013.11.00

• 临床研究 • 上一篇    下一篇

中心静脉长期置管在维持性血液透析患者中的应用

商惠萍,王芳芳,白瑜,郭金艳,李德天   

  1. 中国医科大学附属盛京医院
  • 收稿日期:2013-05-10 修回日期:2013-06-26 出版日期:2013-11-12 发布日期:2013-11-12
  • 通讯作者: 李德天 E-mail:lidetian126@163.com

To investigate the use of long-term central venous catheter in maintenance hemodialysis patients

  • Received:2013-05-10 Revised:2013-06-26 Online:2013-11-12 Published:2013-11-12

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摘要： 目的 分析中心静脉长期导管在维持性血液透析患者中的应用及其常见并发症和处理。方法 回顾性调查339例我院留置的中心静脉长期导管,分析导管在置管和使用过程中的并发症及相应处理对策。结果 置管成功率100%.随访过程中35人死亡,非导管相关。余下304人导管平均留置时间20.0±15.9月。置管过程并发症:导丝送入困难2例,渗血3例,心悸4例,锁骨下静脉损伤1例,成角扭转1例。导管使用过程中并发症:感染11例，流量不足24例,管头裂缝1例。共拔管25例。结论 对于维持性血液透析患者，如果不适于建立动静脉内瘘，中心静脉长期置管可作为患者理想的血管通路，但需注意预防和处理各种并发症。

关键词: 维持性血液透析, 中心静脉长期置管, 并发症

Abstract: Objective To investigate the complications and the treatments of long-term central venous catheter in maintenance haemodialysis patients. Method To retrospective review 339 cases of long-term central venous catheter indwelled in our hospital,and analyse the complications and management during catheterization and use . Results The success of catheterization is 100%.35 patients dead during follow-up process, non of them is catheter-associated.The catheters’ average retention time of the rest 304 patients is 20.0±15.9 months. The major complications during catheterization:the guide wire can not enter the blood vessels in 2 cases,errhysis in 3 cases,palpitate in 4 cases,subclavian vein injuried 1 case,angle of torsion 1 case.Complications in catheter use process:catheter infection in 11 cases,lack of flow 24 cases,the head tube cracks in 1 case.The total of extubation is 25cases. Conclusion For the persistent hemodialysis patients who were not suitable to establish the arteriovenous fistula, the long-term tunneled central venous catheter could be used as vascular access ideally, except that we should pay attention to preventing and treating the complications.

Key words: persistent hemodialysis, long-term central venous catheter, complication