个体化涤纶套中央静脉导管置入方法的安全性及成功率分析  

The safety and success rate of different Individual cuffed catheter central venous catheter insert methods

作　　者：李康峰[1] 严连喜[1] 周玉坤[1] 石平[1] 汤小芳[1] 张玉强[2] 

机构地区：[1]第二军医大学长征医院南京分院肾内科,南京210015 [2]解放军肾脏病研究所第二军医大学长征医院肾内科

出　　处：《临床内科杂志》2013年第1期22-24,共3页Journal of Clinical Internal Medicine

摘　　要：目的观察不同带涤纶套中央静脉导管置入方法的安全性及手术成功率。方法46例患者行带涤纶套中央静脉导管置人术，分为A组（经撕脱鞘方法置管）、B组（经颈外静脉入路置管）和C组（非撕脱鞘方式置管）。观察3组患者手术成功率和术中、术后并发症情况，记录透析中血流量、静脉压指标，计算尿素清除指数（Kt／V），B、C两组与经典撕脱鞘方法置管相对比。结果经典撕脱鞘置管患者均一次性成功，但术中出血量多于另外两组。术后3组均表现为皮下隧道渗血。3组患者透析中静脉压、血流量及Kt／V值比较差异均无统计学意义。非撕脱鞘方式置入导管寿命低于经撕脱鞘置管（P〈0．05）。B、C两组患者手术总失败率（24．14％）高于经典撕脱鞘方式置管患者（P〈0．05）。结论带涤纶套中央静脉导管置入方法推荐首选经典撕脱鞘置管，该方法安全成功率高，术后并发症少。Objective To observe the safety and success rate of different individual cuffed cathe- ter central venous catheter insert methods. Methods 46 patients of cuffed central venous catheters insert were divided into group A used avulsion sheath catheter method,group B by jugular vein insert cuffed cen- tral venous catheter and group C by the way of non-avulsioninsert cuffed central venous catheters method. Intraoperative, postoperative complications were observed, Kt/V values were calculated. Dialysis blood flow,venous pressure were recorded. Results Groups B and group C comparing with the classic avulsion sheath insert, classic avulsion sheath cathete method was one-time success, and hemorrhage was than that of the other two groups. All three groups showed subcutaneous tunnel hemorrhage after the operation. There was no statistically difference in dialysis venous pressure, blood flow, and Kt/V values among group A, groups B and group C. Catheter lifetime of non-avulsioninsert method less than avulsion sheath catheter method（P 〈 0.05）. The overall failure rate of groups B and group C operations（24.14% ） was higher than classic avulsion sheath insert method. Conclusion Classic avulsion sheath catheter method was as the preferred for cuffed catheter central venous catheter insert method, and it was a safety and a higher success rate method with fewer complications.

关 键 词：血液透析 涤纶套导管 出血 并发症 

分 类 号：R472.9[医药卫生—护理学]