中国血液净化

›› 2007, Vol. 6 ›› Issue (7): 379-381.

• 论著 • 上一篇    下一篇

小儿血液净化临时性血管通路的建立

高 岩 邓会英 陶建平 朱丽萍 邓婉贞 张伟平 张国强

  

  1. 510120 广州，广东省广州市儿童医院肾内科
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2007-07-12 发布日期:2007-07-12

  • Received:1900-01-01 Revised:1900-01-01 Online:2007-07-12 Published:2007-07-12

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摘要：

目的 探讨经不同途径建立小儿血液净化临时性血管通路的可行性和安全性。方法 对广东省广州市儿童医院肾内科行血液净化治疗的152 例患儿分别根据患儿病情、年龄和合作程度选择经外周血管直接穿刺、颈内静脉插管、股静脉插管法建立小儿血液净化临时性血管通路。结果 120例外周血管直接穿刺法90.0%穿刺成功，42例颈内静脉置管80.9%成功，10例股静脉插管100.0%成功。颈内静脉置管组, 股静脉置管组和外周血管直接穿刺组血流量分别是(6.10±1.81)ml/(kg·min)，(4.91±0.58)ml/(kg·min)和(3.90±0.63)ml/(kg·min)。无1例患儿有血肿、感染、血栓形成等并发症。结论 5岁以上合作的患儿经外周血管直接穿刺和5岁以下或各种原因所致外周血管的无法穿刺者，经颈内静脉穿刺置管建立血液净化临时性血管通路安全性好、成功率高。颈内静脉置管的血流量优于股静脉，股静脉优于外周血管直接穿刺法。

关键词: 小儿, 血管通路, 临时性, 血液净化

Abstract: Objective To investigate the safety and feasibility of different methods for provisional vascular access in children requisite for blood purification. Methods Puncture of peripheral blood vessel and catheterization of internal jugular or femoral vein were used in 152 children for blood purification. Results Peripheral blood vessel puncture was performed in 120 cases and successfully used in 108 (90%) cases. Internal jugular vein catheterization was carried out in 42 cases and could be used in 34 (80.9%) cases, and femoral vein catheterization was used in 10 (100%) cases. Blood flow rate ml/(kg·min) ranged to (6.10+1.81), (4.91+0.58) and (3.90+0.63) in vascular access through internal jugular vein, femoral vein and peripheral blood vessel, respectively. No complications of hematoma, thrombokinesis and infection were found in any cases. Conclusion For safe and successful establishment of temporary vascular access for blood purification in children, peripheral blood vessel puncture is appropriate for cooperative children above 5 years old. Internal jugular vein catheterization is suitable for children less than 5 years or children inaccessible to peripheral vessels. Of the three access methods, internal jugular catheterization achieved the biggest blood flow rate and peripheral vessel puncture showed the least blood flow rate.

Key words: Provisional, Children, Blood purification

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