关键词: 导管, 留置, 深静脉；肾透析；并发症

Abstract: 【Abstract】 Objectives To compare the safety and usability of the two insertion methods, pull-apart sheath method and guide wire method, for the insertion surgery of indwelling Permcath dialysis catheter.  Methods Two dialysis centers were involved in this study from September 2009 to December 2011. The patients who were arranged to use indwelling Permcath dialysis catheter were enrolled and divided into two groups, the use of pull-apart sheath method group (PAS group) and the use of guide wire group (WG group). Patients’ baseline information as well as the results of blood counts and blood coagulation tests were collected before and after the insertion surgery. Prospective observation was carried out since 24 hours after the insertion. The primary endpoint was the amount of blood loss during the insertion procedure; the secondary endpoints were the time spent for catheterization and the incidence of wound bleeding event within 24 hours after the insertion.  Results There were 22 patients in the PAS group and 23 patients in the GW group. The baseline information was basically similar between the two groups. Compared with the PAS group, the GW group had significantly less blood loss during insertion procedure (4.04±2.09ml vs. 12.86±3.35ml, P=0.000), shorter catheterization time (26.30±3.22min vs. 34.36±2.98min, P=0.000), and lower incidence of wound bleeding event within 24 hours after the insertion (4.358% vs. 27.27%, P=0.047). Conclusions The insertion of Permcath catheter by using guide wire can significantly reduced blood loss during insertion procedure, time spent for catheterization, and incidence of wound bleeding within 24 hours after the insertion, compared that by using pull-apart sheath method.

Key words: Catheter, Indwelling, Deep vein, Renal dialysis, Complication