天津医药

• 短篇论著 • 上一篇    下一篇

62例血液透析患者左侧颈内静脉永久性中心静脉导管早期应用分析

杨涛,张丽红,侯西彬,詹申,李大胜,任树风,王玉柱   

  1. 北京市海淀医院
  • 收稿日期:2011-10-24 修回日期:2012-04-23 出版日期:2012-10-15 发布日期:2012-10-15
  • 通讯作者: 王玉柱

Analyzing to sixty-two hemodialysis patients with chronic central venous catheter in left jugular vein in early stage for hemodialyzing.

  • Received:2011-10-24 Revised:2012-04-23 Published:2012-10-15 Online:2012-10-15

PDF (PC)

2348

摘要： 目的 探究经左侧颈内静脉永久性导管置管早期导管功能不良的发生情况。方法62名终末期肾病患者，左侧颈内静脉置入永久性中心静脉导管。根据是否发生导管功能不良分为A、B两组，考察两组间相应参数的区别，观察前3次透析泵控血流量与相应参数的相关性。结果 两组透析泵控血流量分别为261.5±21.6及235.2±44.5ml/min，差别有统计学意义（P＜0.01）；两组间在年龄、性别、身高、体质量、血红蛋白、血小板、白蛋白、活化部分凝血活酶时间及导管动静脉端所处位置构成上差别无统计学意义（P＞0.05）。泵控血流量只与活化部分凝血活酶时间存在相关性（r=0.302，P=0.017）。结论经左侧颈内静脉置入永久性导管的患者早期导管功能不良发生率较高，导管末端位置并不是早期导管功能的影响因素，选择合适的抗凝剂可减少导管功能不良的发生。

关键词: 血液透析, 永久性中心静脉导管, 左侧颈内静脉, 导管功能不良

Abstract: Objective To observe the blood volume in early stage for hemodialyzing with chronic central venous catheter in left jugular vein, analyze the reasons to the catheter dysfunction. Methods Sixty-two end stage renal disease patients were recruited. The places where the catheters were inserted were in left internal jugular veins. The subjects were classified into two groups according to the catheter function. X ray in chest were taken to determine the catheter tip position. Their ages, body height, hemoglobin, platelets, activated partial thromboplastin time and albumin were collected. Relevance between blood volume in hemodialysis and other parameters were analyzed too. Results The volume of blood flow in dialyzing were 261.5±21.6ml/min and 235.2±44.5ml/min separately (P=0.003). And the dysfunction rates between tip position located in atrium and other positions weren’t different (P=0.263). Relevance were found between blood volume and activated partial thromboplastin time(r=0.302, P=0.017). Conclusion. The rate of catheter dysfunction is higher in patients with chronic catheter in left jugular vein. Adjust the position of the catheter when the position of the catheter isn’t in the proper location. The incidence of catheter dysfunction will be reduced if some drugs such as warfarin were taken.

Key words: Hemodialysis, Chronic central venous catheter, Left jugular vein, Catheter dysfunction