中心静脉插管与直接动脉穿刺血透治疗比较

目的：观察中心静脉插管（CVC）和直接动脉穿刺（AP）的透析效率，可维持透析时间及并发症并进行比较。方法：50例血透病人，22例行CVC（双腔静脉导管）单针单泵透析；28例行AP透析，于透析前，透析后不同时间采血查肾功，电解质，HCO3^-浓度。结果：CVC及AP对BUN，血Ca^2 ,P^3-浓度的影响相似（P＞0．05），而首次透析2h后血K^ ,HCK3^-浓度的变化似与其相应透析前浓度测定值的水平有关，Scr浓度变化（降低），AP组大于CVC组（P＜0．05），可能由于存在通路再循环的影响，CVC常见并发症为感染，细菌为表皮葡萄球菌，AP常见并发症仍为血肿或动脉瘤，结论：CVC与AP作为临时性血管通路的短期透析效率相似，但CVC有减少穿刺，保护血管的优点。

Comparison between central venous catheter(CVC) and atrerio-puncture(AP) in hemodialysis

Objective: To compare the effects of CVC and AP in hemodialysis(HD). Methods: In 50 cases, 22 had CVC HD and 28 had AP HD. Blood BUN, Cr, K-+,Ca 2+ ,P3- ,HCO 3level were examined before and after HD. Results: The effects of CVC and AP HD on blood BUN, Ca 2+ and P 3- after two hours HD were perhaps related to the their levels before HD. In AP HD, the decrease of Scr was more than that of CVC HD(P<0.05). Conclusion: CVC HD and AP HD all reduce the levels of blood BUN, Cr, K + and increase the level of HCO 3 -.The common complication of CVC is infection and the common organism is staphylococcus epidermidis. As a method of temporary vascular access, CVC has less venous demages.