长期深静脉置管在慢性肾衰竭血液透析患者中的应用(1)
【摘要】 目的 评价长期深静脉留置导管作为血液透析通路的效果。方法 采用Seldinger 技术穿刺深静脉,留置导管通过撕脱型外套送入血管。结果 共计30例患者, 其中颈内静脉28例,股静脉2例。留置最长时间达35.5个月,平均导管留置时间为7.5个月。3例因患者烦躁而自行拔出,2例患者因感染无法控制拔管,其余25例患者仍然继续应用该导管透析。结论 长期深静脉留置导管使用时间长,栓塞率、感染率低,可满足血液透析要求, 值得推广应用。【关键词】长期深静脉置管; 血液透析; 透析通路
Application of long-term deep vein catheterization in patients receiving hemodialysis ZHOU Wei-hua.Dialysis Center, the First Hospital ofShangqiu City, Henan 476000, China
【Abstract】 Objective To evaluate the effects of long- term deep vein catheterization as permanent hemodialysis access. Methods Catheterization was performed in patients by the standard seldinger technique, that a guidewire was inserted into a deep central vein, following by the insertion of the cuffed catheter through a peel- away sheath. The duration and various outcomes of catheterization were evaluated.Results Among the 30 patients with long- term deep vein catheterization, catheters in 28 patients were inserted through internal jugular veins and 2 patients through femoral veins. The average duration of catheterization was 7.5 months, the longest duration in a patient was 35.5 months. Catheterization was terminated in 5 patients,within who two due to uncontrollable infections, and two patients pulled outthe catheter by himself due to emotional restlessness. The remaining 25 patients were still under catheterization by the end of the study. Conclusions Long- term deep vein catheterization has long effective duration and low rate of embolism and infection. It can meet the relative needs for hemodialysis, therefore it should be extensively applied as a hemodialysis access. ......
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