中心静脉置管路径在血液透析中的疗效和安全性分析

摘要

目的：比较两种路径中心静脉置管在血液透析中的疗效和安全性。方法回顾性分析87例接受血液透析的患者，按照置管路径分为两组：颈内静脉入路组42例，股静脉入路组45例。记录两组患者的透析充分性指标：尿素氮下降率（URR）、尿素清除指数（Kt／V），与导管相关的近期及远期并发症，并进行统计学比较。结果颈内静脉入路组的透析充分性指标 URR 及 Kt／V 均高于股静脉入路组（P ＜0．05），而与导管相关的远期并发症血栓形成率及感染率均低于股静脉入路组（P ＜0．05），与导管相关的近期并发症两组比较差异无统计学意义（P ＞0．05）。结论经皮颈内静脉置管是血液透析患者首选的临时性血管通路。%Objective To assess the efficacy and safety of central venous catheter insertion through two approaches in hemo-dialysis.Methods The data of 87 hemodialysis patients were retrospectively analyzed.The patients were divided into two groups:42 cases in internal jugular vein catheterization (IJVC)group,and 45 cases in femoral vein catheterization (FVC) group.Urea reduction ratio (URR),urea clearance index (Kt/V),correlative acute and chronic complications were observed and calculated.Results Urea clearance divided by URR and Kt/V in IJVC group were higher than those in FVC group (P <0.05).The incidences of thrombus and infection in IJVC group were lower than those in FVC group (P <0.05).There were no differences of the correlative acute complications between two groups (P >0.05).Conclusion Internal jugular vein catheteriza-tion is the first choice of temporary blood access for hemodialysis patients.