改良法置入深静脉双腔半永久性导管建立血液透析通路应用体会

目的观察改良法经颈内静脉留置半永久性导管的可行性和安全性。方法选择2009年11月至2011年3月接受血液净化治疗患者19例,均为血管条件差或多次内瘘手术失败无法建立动静脉内瘘。术前均接受颈部血管彩色多普勒检查,明确右颈内静脉位置、有无血栓形成。如右颈内静脉血栓形成或狭窄,则采用左侧颈内静脉。所有患者均使用改良法置入双腔半永久性导管。结果 19例置管均一次性手术成功,术中出血少,无空气栓塞等严重并发症。术后恢复良好。术后次日患者即经半永久性导管进行血液透析,最高血流量可达280 ml/min以上,流速稳定,无导管吸壁现象发生,完全可满足血液透析需要。平均留置时间（7.5±4.4）个月,最长留置14个月。结论改良法置入深静脉双腔半永久性透析管实用、简便、安全,值得临床推广。

Insertion of the semipermanent cuffed catheter as vascular access for hemodialysis by a modified method

Objective To assess feasibility and safety of the modified method to insert a semipermanent cuffed catheter as vascular access for hemodialysis.Methods 19 patients was enrolled for this study who received hemodialysis in our department during Nov 2009 to Mar 2011.All of the patients could not establish arteriovenous fistula because of their poor vessel condition or more than one failure in their fistula.Every patient performed Ultrasonography examination,in order to make sure the position of the right jugul...