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1、徐州醫(yī)學(xué)院學(xué)報(bào)ACTAACADEMIAEMEDICINAEXUZHOU2011,31(12)·809·帶cuff血液透析導(dǎo)管頸內(nèi)靜脈長(zhǎng)期留置臨床分析胡軍建,徐建華,任月運(yùn),楊靖(徐州市腫瘤醫(yī)院腎內(nèi)科,江蘇徐州221005)摘要:目的總結(jié)分析維持性血液透析(血透)患者頸內(nèi)靜脈長(zhǎng)期留置帶cuff血透導(dǎo)管相關(guān)資料,以期更好保護(hù)導(dǎo)管,延長(zhǎng)使用壽命。方法選擇維持性血透患者56例,長(zhǎng)期留置帶cuff血透導(dǎo)管,觀察并記錄一般實(shí)驗(yàn)室檢查、血壓、腎衰竭病因、置入帶cuff長(zhǎng)期導(dǎo)管的原因、導(dǎo)管類型、手術(shù)入路、導(dǎo)管相關(guān)并發(fā)癥(感染、血栓形成
2、等)、導(dǎo)管使用壽命及退出原因。結(jié)果現(xiàn)階段應(yīng)用帶cuff血透導(dǎo)管作為血管通路者21例,占同期透析患者的19.23%。最長(zhǎng)使用時(shí)間37.6個(gè)月,平均時(shí)間(32.2±3.2)個(gè)月。血流量200~300ml/min。并發(fā)癥情況:出口感染2例,導(dǎo)管相關(guān)菌血癥9例,導(dǎo)管扭曲、位置不適當(dāng)2例,血栓性并發(fā)癥8例,導(dǎo)管完全脫出1例,部分脫出1例。所有并發(fā)癥均進(jìn)行適當(dāng)治療。結(jié)論帶cuff血透導(dǎo)管作為長(zhǎng)期血管通路使用安全有效,可以作為等待動(dòng)靜脈內(nèi)瘺成熟期間較理想的過(guò)渡通路。規(guī)范化管理、預(yù)防和治療并發(fā)癥是留置帶cuff血透導(dǎo)管管理的重點(diǎn)。關(guān)鍵
3、詞:血液透析;帶滌綸環(huán)血透導(dǎo)管;并發(fā)癥中圖分類號(hào):R459.5文獻(xiàn)標(biāo)志碼:A文章編號(hào):1000-2065(2011)12-0809-04Theretrospectiveanalysisofindwellingvenoustunneledcuffedcathetersforpermanentusein56maintenancehemodialysispatientsHUJunjian,XUJianhua,RENYueyun,YANGJing(DepartmentofNephrology,XuzhouCancerHospi
4、tal,Xuzhou,Jiangsu221005,China)Abstract:ObjectiveToreviewandanalyzetherelatedinformationof56maintenancehemodialysispatientswithinternaljugularveinlong-termindwellingcatheterwithcuff,soastobetterprotectlong-termcatheterandprolongservicelife.Methods56patientsunder
5、goingmaintenancehemodialysiswithlong-termindwellingcatheterwithcuff,wererecruitedinthestudytoobserveandrecordgenerallaboratory,bloodpressure,kidneyfailurereason,thecauseofindwellingcatheterwithcuff,cathetertype,surgicalapproach,catheterrelatedcomplications(infec
6、tion,thrombosis,etc),catheterservicelifeandtheexitreasons.ResultsAtpresentapplicationtunneledcuffedcatheterforhemodialysisas21cases,accountingforthesameperioddialysiscentersofdialysispatients19.23%.Thelongestusetimewas37.6months,theaveragetimewas(32.2±3.2)months
7、.Theflowofbloodwas200-300ml/min.Complicationssituation:includingexportinfectionin2cases,catheter-relatedbacteraemiain9cases,catheterdistortionandpositionwasnotap-propriate2cases,thrombosis8casesofcomplications,cathetercompletelyemergein1case,partemergein1case.Al
8、lthecomplicationswereappropriatelytreated.ConclusionTaketunneledcuffedcatheteraslong-termvascularaccessusesafeandeffective,andcanbeusedasawaitingforarteriovenousfistu