中国血液净化

中国血液净化 ›› 2025, Vol. 24 ›› Issue (12): 1037-1040.doi: 0.3969/j.issn.1671-4091.2025.12.015

• 血管通路 • 上一篇    下一篇

双导丝破鞘技术在纤维蛋白鞘形成带涤纶套导管换管中的应用

郜同心    何聪爽    李江利    刘振雅    杨 涛   

  1. 100080 北京，1北京市中关村医院肾内科
  • 收稿日期:2025-04-14 修回日期:2025-08-12 出版日期:2025-12-12 发布日期:2025-12-12
  • 通讯作者: 杨涛 E-mail:yangtaodoctor@163.com

Application of double guide wire combined technique in in situ replacement of tunnel-cuffed catheter

GAO Tong-xin, HE Cong-shuang, LI Jiang-li, LIU Zhen-ya, YANG Tao   

  1. epartment of Nephrology, Beijing zhongguancun Hospital, Beijing 100080, China
  • Received:2025-04-14 Revised:2025-08-12 Online:2025-12-12 Published:2025-12-12
  • Contact: 100080 北京，1北京市中关村医院肾内科 E-mail:yangtaodoctor@163.com

摘要： 目的  旨在评价双导丝破鞘技术改善带隧道和涤纶套的透析导管(tunneled-cuffed catheters，TCC)长期通畅率的有效性。 方法 回顾性分析2024年1月1日—9月30日北京市中关村医院因纤维蛋白鞘更换TCC的病例，使用双导丝破鞘技术更换导管，收集患者临床资料、手术信息，并追溯180 d内的随访信息，评价导管通畅情况。 结果 共纳入30例患者，使用双导丝破鞘技术更换透析导管手术成功率100%，患者围手术期均未发生大出血、心包填塞、导管相关感染等手术相关并发症。导管更换后90 d、180 d初级通畅率分别为93.3%、80.0%。90 d、180 d初级辅助通畅率分别为100%、90.0%。 结论 双导丝破鞘技术在纤维蛋白鞘形成带涤纶套导管换管中是一种安全有效的方法。

关键词: 维持性血液透析, 中心静脉导管, 原位换管, 导管相关纤维蛋白鞘

Abstract: Objective  This study aims to evaluate the effectiveness of double guide wire technique through the binding of fibrin sheath to improve long-term patency rate of tunneled-cuffed catheter (TCC).  Methods  A retrospective study was conducted on the patients undergoing TCC replacement due to fibrin sheath at Beijing Zhongguancun Hospital from January first to September 30, 2024. Double guide wire technique through the binding of fibrin sheath was used to re-implant TCC. Clinical data, surgical information, and follow-up study within 180 days were collected to evaluate TCC patency.  Results  A total of 30 patients were included in this study. The success rate of TCC replacement using double guide wire to break the fibrin sheath constraint was 100%. No surgery-related complications such as massive hemorrhage, pericardial tamponade and catheter-related infections happened in perioperative period. After catheter replacement for 90 and 180 days, the primary patency rates were 93.3% and 80.0% respectively, and the primary assistant patency rates were 100% and 90.0% respectively.  Conclusion  The double guide wire technique through the binding of fibrin sheath is a safe and effective method for in situ replacement of TCC.

Key words: Maintenance hemodialysis, Central venous catheters, In situ catheterization; , Catheter related fibrin sheath

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