不同途径深静脉置管在血液透析中的比较

目的 比较颈内静脉置管、锁骨下静脉置管及股静脉置管在留置时间以及并发症方面的差异,总结深静脉置管在血液透析中应用的经验教训.方法 选取2007年12月-2010年3月在我院血液净化中心行中心静脉穿刺置管术的患者共190例,比较上述三种置管方法的置管操作并发症、导管留置时间以及导管功能不全、局部静脉梗阻、感染及导管脱落等远期并发症.结果 三种方法的置管成功率相当,颈内静脉置管的并发症少,留置时间最长,血流最稳定,但是出口感染和败血症的发生率较高,通过局部换药和应用静脉抗生素,其预后较好.结论 颈内静脉置管是建立血透临时通路的较好选择,但是应该注意预防出口感染和败血症.

Comparison on different venous catheter settings in hemodialysis patients

Objective To study jugular vein, subclavian vein and femoral vein catheterizations in terms of indwelling time and complications, and sum up experience and lessons of dialysis vein catheterizations. Metbods 190 cases of central venous catheterization from December 2007 to March 2010 in our hemodialysis center were observed retrospectively. The three methods of catheterizations were compared in operation complications, indwelling time,catheter dysfunction, local venous obstruction, infection,catheter disengage and other late complications. Results The success rates of the three methods were similar, jugular vein catheters had less complications and the longest indwelling time, and provided superior blood flow .But jugular vein catheters showed higher incidence of exit site infection and sepsis. Dressing catheter exit sites with dry gauze and antiseptic ointments was good effective to treat exit site infection.Conclusion The internal jugular vein catheterization is a better temporary vascular access for hemodialysis.But exit site infection and sepsis should be paid attention to during the progress.