摘要
目的:探讨带涤纶套透析导管在维持性血液透析患者中的应用及并发症防治。方法:回顾性分析102例以带涤纶套透析导管为血管通路的维持性血液透析患者的临床资料,以内瘘为血管通路的透析患者为对照,对比分析带涤纶套透析导管的相关并发症以及以尿素清除率(Kt/V)为代表的透析充分性的客观评价指标。结果:留置长期带涤纶套导管术102例次,成功101次,成功率99%;留置导管时间分别为:>60月2例,48-60月10例,36-48月19例,24-36月28例,6-24月23例,<6个月20例。共21例次退出,退出时间为2-40月。导管功能良好;血流量均在200-250ml/min,导管透析充分性良好,导管组尿素下降率(URR)=70.42±6.59,Kt/V=1.42±3.48;内瘘组URR=68.66±5.52,Kt/V=1.34±0.17,二者差异无统计学意义(P>0.05),导管组主要并发症为出血、感染、血栓形成。结论:带涤纶套的血液透析导管可保留数月至数年,可以达到充分透析;良好的置管技术及严格的管理,可提高导管的有效使用寿命,预防导管相关并发症发生。
Objective： To analyze the application of tunnel cuffed catheter and treatment of its complica- tions in hemodialysis patients. Methods. The clinical data of 102 maintenance hemodialysis pa- tients with tunnel cuffed catheters as their vascular accesses were analyzed retrospectively. An- other 73 patients with arteriovenous fistulas were set as control group. The complications related to tunnel cuffed catheters and the objective indicator of dialysis adequacy such as urea clearance rate Kt/v were also analyzed. Results： The dual lumen cuffed catheters were successfully implan- ted in 99% （101/102） cases of chronic renal failure （CRF） patients. Catheter indwelling time were as follows： 2 cases longer than 60 months, 10 eases 48-60 months, 19 cases 36-48 months, 28 cases 24-36 months, 23 cases 6-24 months,15 cases 〈 6 months. 21 cases quitted during 2 to 40 months. Both groups were effective in hemodialysis, and no difference were found in the values of Kt/V and urea reduction ratio. The main complications of tunnel cuffed catheter were bleeding, infection, and thrombosis. Conclusion： Indwelling time of tunnel cuffed catheter ranges from sev- eral months to several years, and patients could get adequate dialysis by cuffed catheters hemodi-alysis. Good catheter planting technique and strict procedures are important for effective using catheter and preventing complications.
出处
《武汉大学学报（医学版）》
CAS
北大核心
2013年第2期273-276,共4页
Medical Journal of Wuhan University
