长期深静脉留置透析导管的并发症及护理

目的 探讨长期深静脉留置透析导管患者相关并发症及护理方法.方法 回顾性分析我院2002年10月至2009年10月109例长期深静脉双腔透析导管的使用情况,随访留置导管的并发症及对症处理情况,记录导管使用时间及拔管原因.结果 本组患者导管平均使用时间为（19.8±10.7）个月,导管退出57例次,约占52.3%,导管退出时平均使用时间为（9.8±7.5）个月.109例患者中发生导管相关性感染22例,感染率为20.2%,其中17例为细菌感染,5例为真菌感染;11例导管内血栓形成,发生率为10.1%;导管位置不良4例,发生率为3.7%;3例导管cuff脱落,发生率为2.8%.结论 导管相关性感染、血栓形成及导管位置不良是其最为常见的并发症,良好的导管留置技术和精心的护理可减少并发症的发生,显著延长导管的使用寿命.

Nursing of complications related to long-term deep venous catheterization

Objective Explore the complications related to long-term deep venous catheterization and nursing care. Methods 109 cases with long-term deep venous catheterization from october 2002 to October 2009 were analyzed retrospectively. Incidence and treatment of complication related to long-term deep venous catheterization,time of catheter use and causes of catheter withdrawal were observed and recorded. Results The average time of catheter use was ( 19. 8 ± 10. 7) months. 57 cases had catheter withdrawal (52. 3% ), with average time of catheter use of (9.8 ±7.5) months. 22 out of 109 cases (20.2%) had infection related to catheterization, including 17 cases of bacteria infection and 5 cases of fungi infection. 11 cases had catheter thrombosis ( 10. 1% ), 4 cases had catheter malposition(3.7% ) and 3 cases had cuff falling out (2. 8% ). Conclusions Infection related to catheterization,catheter thrombosis and catheter malposition are the most common complications. Proficient skill of catheterization and intensive nursing care could decrease the incidence of complications related to catheterization and increase the time of catheter use.