中国血液净化

中国血液净化 ›› 2013, Vol. 12 ›› Issue (02): 86-89.doi: 10.3969/j.issn.1671-4091.2013.02.00

• 临床研究 • 上一篇    下一篇

中心静脉置管相关的静脉血栓的解剖分布及血栓形成的影响因素分析

张任重1,赵海霞2,崔天蕾3,付平3   

  1. 1. 四川大学华西医院
    2. 解放军第91医院肾脏内科
    3. 四川大学华西医院肾脏内科
  • 收稿日期:2012-07-27 修回日期:2012-10-13 出版日期:2013-02-12 发布日期:2013-02-12
  • 通讯作者: 付平 fupinghx@163.com E-mail:zhangrenzhong_2009@163.com

Distribution and Risk Factors of Venous Thrombosis Following Catheterization in Patients with End-Stage Renal Disease

  • Received:2012-07-27 Revised:2012-10-13 Online:2013-02-12 Published:2013-02-12

RichHTML

1

PDF

569

摘要： 目的 分析血液透析患者中心静脉置管相关静脉血栓的解剖分布及其形成的危险因素，为临床治疗及预防狭窄的发生提供依据。方法 回顾性分析2010年1月至2012年1月就诊于我院的有右颈内静脉置管史的127患者的CTA血管成像、置管时间、置管次数、血脂、血红蛋白、血白蛋白等相关影像学资料、置管相关数据和实验室指标，根据影像学资料分为血栓组和非血栓组，统计血栓组患者血栓的解剖位置分布并对两组进行比较。结果 根据CTA结果分为血栓组66例，非血栓组61例。血栓组中颈内静脉血栓形成者43例，右无名静脉狭窄者15例，锁骨下静脉狭窄者4例，上腔静脉狭窄者4例；血栓组的导管留置时间、血低密度脂蛋白水平、血胆固醇水平高于非血栓组，差异有统计学意义；血栓组与非血栓组在性别、年龄、血白蛋白、血红蛋白、置管次数及高密度脂蛋白无统计学差异。结论 右侧颈内静脉置管相关血栓依次最常见于颈内静脉、无名静脉、锁骨下静脉、上腔静脉，对于无内瘘使用禁忌症的患者，应尽量避免右颈内静脉导管的长期留置；降低导管留置时间、血浆低密度脂蛋白、血浆胆固醇水平可能有助于减少或延缓中心静脉狭窄的发生。

关键词: 中心静脉置管, 血栓分布, 危险因素

Abstract: Objective To determine thrombosis distribution and risk factors of venous thrombosis following catheterization in patients with End-Stage Renal Disease (ESRD). Methods 127 HD patients have a history of right internal jugular catheterization were performed Computed Tomography Angiography (CTA), their clinical characteristics were examined. Patients were divided into thrombotic group and non-thrombotic group according imaging results and their clinical characteristics were compared between two groups, and the thrombosis anatomy positions of thrombotic group were measured. Result There were 66, 61patients in thrombotic group and non-thrombotic group, respectively. In thrombotic group, 43, 15, 4, 4 patients have there venous thrombosis in right internal jugular vein (RIJV), right innominate vein (RIV), right subclavian vein (RSCV) and superior vena cava (SVC),respectively. There were significant difference between CVS group and non-CVS group in catheter days, low-density lipoprotein cholesterol levels, total cholesterol levels; there were no significant difference between two groups in age, gender, hemoglobin levels, albumin levels, catheterization numbers, total cholesterol, triglyceride. Conclusion The most often anatomic locations of venous formation following right internal jugular venous catheterization in patients with ESRD were RIJV, RIV, RSCV and SVC, respectively, to decrease catheters days, low-density lipoprotein cholesterol levels, total cholesterol levels may be useful for reducing occurrence of CVS.

Key words: Central vein catheterization, Thrombosis distribution, Risk factor

中图分类号: