深静脉置管建立血液透析通路178例临床分析

目的 总结血液净化治疗患者留置临时性中心静脉导管的经验，探讨中心静脉留置导管在血液净化治疗中的应用以及中心静脉留置导管并发症的防治。方法2006年2月-2008年10月，我院肾内科采用3种方法行临时性单针双腔静脉导管留置术血液净化治疗患者178例患者。结果置管术中的常见并发症有：误穿动脉6例（3．4％），皮下血肿8例（4．5％），穿刺部位渗血2例（1．1％）。置管术常见远期并发症有：导管相关感染22例（12．4％），导管栓塞7例（3．9），导管意外脱落3例（1．7％），血流量不足（血流〈180ml／min）21例（11．8％）。结论临时性中心静脉留置导管操作技术简便，并发症低，并能提供稳定血流量，是建立血液净化治疗临时性血液通路的理想选择。

Clinical analysis of 178 cases of central venous catheterization of blood purification therapy

Objective To review the clinical applications, complications and its management of central venous catheterizations in patients undergoing blood purification therapy.Methods A retrospective study was performed in 178 cases of patients undergoing blood purification therapy with central venous catheters during February,2006 to October,2008.Pesults The common acute complications of catheterizations included inadvertent arterial puncture in 6 eases （3.4 % ）, local hematoma in 8 cases （ 4.5 % ） and local bleeding in 2 cases（ 1.1% ）. The common long-term complications of catheterizations included infection in 22 cases（ 12.4% ）, catheter obstruction in 7 eases（3.9% ） ,catheter inadvertent withdrawal in 3 crises（ 1.7% ） and catheter inadeituate blood flow （ 〈 180mol/min）in 21 eases（11. 8 % ）. Conclusion Central venous eatheterizaion has a low rate of complication which can be controlled easily and safely.