正、反向交替使用palindrome导管在血液透析中的应用研究  

Forward and reverse alternative application of palindrome catheter in hemodialysis

作　　者：龚丽娜[1] 彭桂香[1] 杜丽冰[1] 

机构地区：[1]广东佛山市南海区第二人民医院透析中心,佛山528251

出　　处：《新医学》2014年第7期468-471,共4页Journal of New Medicine

摘　　要：目的探讨palindrome导管正、反向交替使用在血液透析中的应用效果。方法选择34例长期留置深静脉导管的血液透析患者,分为palindrome导管组(治疗组,13例)和quinton导管组(对照组,21例),治疗组先正向连接palindrome导管行透析3个月,再正、反向交替连接palindrome导管透析3个月;对照组测量正、反向连接的quinton导管流量及再循环率后正向使用quinton导管6个月。比较2组血栓、感染、再循环和透析充分性、营养等相关指标。结果治疗组正、反向导管血流量均明显大于对照组(P均<0.05),对照组反向血流量明显小于正向(P<0.01),对照组反向使用有4例血流量<200 ml/min;治疗组正、反向再循环率均明显低于对照组(P均<0.01),对照组反向再循环率明显高于正向(P<0.01),治疗组正、反向再循环率比较差异无统计学意义(P>0.05)。治疗组正、反向交替使用血栓形成率明显低于对照组(P<0.05)。各组营养及透析充分性指标比较差异无统计学意义(P>0.05)。结论正、反向交替使用palindrome导管能明显提高透析效能,降低导管再循环率及血栓形成率。Objective To explore the effect of forward and reverse alternative application of palin- drome catheter in hemodialysis. Methods Thirty-four hemodialysis patients with long-term indwelling deep venous catheters were selected, and divided into palindrome catheter group （treatment group, n = 13 ） and quinton catheter group （control group, n = 21 ）. Patients in treatment group were dialyzed by connecting forward of palindrome catheter for three months, and then connecting forward and reverse alternately for three months. After flow and recirculation rate measured, patients in control group were dialysis by connecting forward of quinton catheter for six months. Indexes such as thrombosis, infection, recirculation and dialysis adequacy, and nutrition between two groups were compared. Results Forward and reverse blood flows of catheter in treatment group were significantly more than those in control group （ P 〈 0. 05 ）. In control group, reverse flow was significantly less than forward blood flow （ P 〈 0. 01 ）. There were 4 patients whose blood flow was less than 20Oral/rain in control group. Forward and reverse recirculation rate in treatment group were significantly lower than that in control group （ P 〈 0. 01 ）. In control group, reverse reeireulation rate was significantly higher than forward （ P 〈 0. 01 ）. There was no significant difference between reeireulation rate of forward and reverse in the treatment group. Thrombosis rate of alternating forward and reverse use in treatment group was significantly lower than that of the control group （ P 〈 0.05 ）. There were no statistical difference of nutrition index such as Hb, Alb, TC, CRP, Kt/v and URR between two groups （ P 〉 0. 05 ）. Conclusion Palindrome catheter used forward and reverse alternately may significantly improve the effect of dialysis, decrease catheterrelated reeirculation and infection rates.

关 键 词：血液透析 血管通路 palindrome导管 

分 类 号：R459.5[医药卫生—治疗学]