中心静脉留置导管在血液透析中的应用

目的 总结中心静脉置管(CVT)在血液透析中的应用,探讨导管合理留置时间和并发症的防治。方法 回顾性分析九年间我院血液净化中心对783例急、慢性肾衰患者,穿刺股静脉、锁骨下静脉和颈内静脉三个部位CVT共806例次,其中股静脉192,锁骨下静脉263,颈内静脉351例次。结果 导管留置时间:股静脉3～45(18.7±12.2)天;锁骨下静脉14～171(43.9±27.8)天;颈内静脉16～92(43.6± 22.1)天。CVT并发症发生率为12.7％,常见的有感染(4.7％),血流不畅(3.2％),出血(2.0％),局部血肿(1.5％),深静脉血栓形成(1.2％)。结论 血透应用CVT有快捷、方便、安全的优点,导管留置时间:锁骨下和颈内静脉无显著性差异,但比股静脉明显延长。并发症的发生率股静脉最高,其次为锁骨下和颈内静脉。

Application of central venous catheter (CVT) in hemodialisis

Objective To review the complications and keeping duration for cential venous catheter (CVT) in hemodialisis patients. Methods 806 CVT procedures were performed in 593 renal failuie patients during last 9 years in this retrospective study.which include 192 femoral venous catheterization, 263 subclavian and 351 intemal jugular. Results Time of CVT were kept for: femaral: 3 - 45(18.7 12.2)days; subclavian: 14- 171(43.9 27.8)days; internai jugular: 16 - 92(43.6 22. 1)days. Comph'cations rate of CVT was 12.7%, which inelude infecn'on (4.7%) , thrombosis (3.2% ), hemoirhage(2.0%), local hematoma (1.5%),deep venous thrombosis (1.2%). Conclusions Our date diows diat the duration of CVT is subclavian equal to internai jungular, Subclavian and intemal jungular more than femoral. The incidence of com-plicatiori is femoral the most, subcalvinan more than internai jungular.