股静脉穿刺置管临床并发症发生及处理分析

目的探讨双腔股静脉穿刺置管术患者临床并发症的发生情况及处理方法,总结以后穿刺及对并发症的处理经验。方法以2008年9月～2011年9月我科243例因各种原因需行血液净化治疗而建立临时双腔股静脉穿刺置管术的患者为研究对象,分析其临床并发症的发生情况及处理方法。结果 243例双腔股静脉置管患者中,置管成功者239例(98.4%),置管失败者4例(1.6%)。置管术后至2周内出现导管不通畅或导管完全阻塞16例(6.5%);导管相关性菌血症10例(4.1%);留置导管周围渗血9例(3.7%),留置导管滑脱4例(1.6%),局部血肿形成3例(1.2%),术侧下肢肿胀3例(1.2%),动静脉瘘1例(0.4%)。结论股静脉穿刺留置导管作为肾内科常规治疗手段,具有穿刺置管成功率高,操作技术相对简单,风险小,能保证足够血流量的优点。在急慢性肾衰竭、中毒及内外科其他多种危急重症的抢救、治疗中有重要的应用价值。

Femoral vein catheterization clinical complications and the processing and analysis

Objective Investigate the double-lumen femoral vein catheterization in patients with clinical complications and treatment,summed up after the puncture and complications of treatment experience.Methods Temporary double-lumen femoral vein catheterization in patients with established department from September 2008 to September 2011 243 cases due to various reasons need blood purification therapy for the study,analysis of the occurrence and treatment of clinical complications approach.Results 243 cases of double-lumen femoral vein catheterization in patients with catheter successful in 239 cases(98.4%),catheter losers of four cases(1.6%).Catheter after surgery to 2 weeks,the catheter is not smooth or catheter is completely blocked in 16 cases(6.5%);catheter-related bacteremia in 10 cases(4.1%);around the catheter insertion bleeding in 9 cases(3.7%),indwelling catheter slippage in four cases(1.6%),local hematoma formation in three cases(1.2%),the technical side of the lower limb swelling in 3 cases(1.2%),arteriovenous fistula(0.4%).Conclusion Femoral vein indwelling catheter as the conventional treatment of renal medicine,with a high success rate of catheterization,operative technique is relatively simple,small risk,to ensure adequate blood flow advantages.Important applications in the rescue of a variety of other emergency and severe acute and chronic renal failure,poisoning and surgical treatment.