›› 2009, Vol. 8 ›› Issue (6): 309-312.

• 论著 • Previous Articles     Next Articles

Application of indwelling central venous catheterization in hemodialysis

FU Xiao, ZHU Xiao-ping, WU Hong, YUAN Fang, CHEN Xing   

  1. Department of Nephrology, The Second Xiangya Hospital of Central South University, Changsha 410011, China
  • Received:2008-09-16 Revised:1900-01-01 Online:2009-06-12 Published:2009-06-12

Abstract:

【Abstract】 Objective To analyze the complications resulting from central vein catheterization and their treatment in hemodialysis patients. Methods A retrospective study was performed on 1269 cases treated with hemodialysis using central venous catheters during January, 2005 to September, 2007. Of them, 409 had catheterizations through femoral vein, 544 through external jugular vein, 285 through internal jugular vein, and 31 had permanent catheterizations. Result The average indwelling time of the catheters was 3 weeks for catheterizations through femoral vein, 4 months for those through internal or external jugular vein, and 11 months for permanent catheterizations. The acute complications of the catheterizations included inadvertent puncture to arteries (2.36%), hematoma (2.13%) and local blood infiltration (1.26%). The complications of long-term indwelling catheterizations were infection (6.38%) and insufficient blood flow through catheter (5.04%). Infections included local infection (6.38%) and catheter infection (2.83%). The local infection rate and catheter infection rate were highest (10.27% and 3.67%, respectively) in patients with catheterization through femoral vein, resulting in shorter indwelling duration in these patients. The infection rate had no difference between patients through internal and external jugular vein catheterizations. We changed dressing everyday for local infection, and sealed the catheter with gentamicine 80,000 units and urokinas 10,000 units for catheter infection. If the catheter infection improved after this sealing method for 2-3 times, we continued to use this method for 2 weeks. If this sealing method was no useful, we removed the catheter. The causes of insufficient blood flow through catheter included the catheters adhered to vessel wall, angled and blocked by thrombosis in it, which were usually seen in patients using cuffed catheter. Change of catheter position was usually found in catheterization through external jugular vein (2.57%), probably due to the local anatomical features. Conclusion Central venous catheterization is an ideal vascular access for hemodialysis. However, careful must be paid to the appropriate indications, skilled operation technique, and prevention and treatment of its complications.

Key words: Vascular access, Central vein catheterization, Complication

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