长期留置中心静脉导管在血液透析患者中的临床应用研究

摘要

目的：观察长期留置中心静脉导管（TCC）在血液透析中的可行性。方法：30例无法建立血管内瘘的患者，采用Permcath双腔导管作右侧颈内静脉内置入。结果：30例均一次性置管成功，期间发生血栓形成或血流不畅2例，感染2例，出血2例，经处理后消失。除4例死亡外（非导管因素），其余均在继续透析中，血流量在200~300 mL/min之间。透析充分性与动静脉内瘘（AVF）患者比较差异无统计学意义（P>0.05）。结论：TCC长期导管安全性能高，能满足临床透析需要，为维持性透析患者建立血管通路的极好补充形式。%Objective:To observe the feasibility of the clinical application the tunneled cuffed catheter(TCC)in hemodialysis. Method:Thirty patients who cannot be established endovascular fistula were adopted in Permcath dual cavity catheter which was put in the right internal jugular vein. Result:Thirty cases were all succeeded in catheter,and thrombosis or poor blood flow occurred in 2 cases,infection in 2 cases,hemorrhaged in 2 cases, which disappeared after the treatment. Except 4 cases died(Not-TCC factors),the rest were on dialysis,whose blood flowed from 200 to 300 mL/min. There was no difference between TCC and Arteriovenous fistula(AVF)in dialysis adequacy(P>0.05). Conclusion:TCC is safe enough to meet the clinical dialysis,which is an optimal and alternative vascular access for maintenance patients in hemodialysis.