带cuff血液透析导管颈内静脉长期留置临床分析

目的 总结分析维持性血液透析（血透）患者颈内静脉长期留置带cuff血透导管相关资料,以期更好保护导管,延长使用寿命.方法 选择维持性血透患者56例,长期留置带cuff血透导管,观察并记录一般实验室检查、血压、肾衰竭病因、置入带cuff长期导管的原因、导管类型、手术入路、导管相关并发症（感染、血栓形成等）、导管使用寿命及退出原因.结果 现阶段应用带cuff血透导管作为血管通路者21例,占同期透析患者的19.23%.最长使用时间37.6个月,平均时间（32.2±3.2）个月.血流量200～300 ml/min.并发症情况：出口感染2例,导管相关菌血症9例,导管扭曲、位置不适当2例,血栓性并发症8例,导管完全脱出1例,部分脱出1例.所有并发症均进行适当治疗.结论 带cuff血透导管作为长期血管通路使用安全有效,可以作为等待动静脉内瘘成熟期间较理想的过渡通路.规范化管理、预防和治疗并发症是留置带cuff血透导管管理的重点.

The retrospective analysis of indwelling venous tunneled cuffed catheters for permanent use in 56 maintenance hemodialysis patients

Objective To review and analyze the related information of 56 maintenance hemodialysis patients with internal jugular vein long - term indwelling catheter with cuff, so as to better protect long - term catheter and prolong service life. Methods 56 patients undergoing maintenance hemodialysis with long- term indwelling catheter with cuff, were recruited in the study to observe and record general laboratory, blood pressure, kidney failure reason, the cause of indwelling catheter with cuff , catheter type, surgical approach, catheter related complications （infection, thrombosis, etc）, catheter service life and the exit reasons. Results At present application tunneled cuffed catheter for hemodialysis as 21 cases, accounting for the same period dialysis centers of dialysis patients 19.23%. The longest use time was 37.6 months, the average time was （32.2 ± 3.2） months. The flow of blood was 200 - 300 ml/min. Complications situation ： including export irrfection in 2 cases, catheter - related baeteraemla in 9 cases, catheter distortion and position was not appropriate 2 cases ,thrombosis 8 cases of complications ,catheter completely emerge in 1 case, part emerge in 1 case. All the complications were appropriately treated. Coneluslon Take tunneled cuffed catheter as long - term vascular access use safe and effective, and can be used as a waiting for arteriovenous fistula in the mature period ideal transition pathways. The standardization of management, prevention and treatment of complication is the key management of tunneled cuffed catheter.