血液透析患者中心静脉置管功能不良因素分析  

Analysis of the factors relating to central venous catheter dysfunction in hemodialysis patients

作　　者：林玲[1] 汪永辉 LIN Ling;WANG Yon-ghui(Department of Nephrology, Hubei Corps Hospital of The Armed Police, Wuhan 430061, China.)

机构地区：[1]武警湖北总队医院肾内科,武汉市430061 [2]湖北中医药大学黄家湖医院内科,武汉市430000

出　　处：《临床合理用药杂志》2018年第16期51-52,共2页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的分析血液透析患者长期中心静脉置管功能不良因素。方法选取2009年1月-2013年12月我透析中心采用中心静脉导管建立长期透析通路6个月以上的患者80例,按有无导管功能不良分为2组,出现导管功能不良患者45例为观察组,未出现导管功能不良患者35例为对照组,比较2组患者的一般情况,并分析导管功能不良的原因。结果 2组患者在年龄、性别、原发病方面无明显差异(P>0.05),但观察组的透析龄明显长于对照组,差异有统计学意义(P<0.05)。2组患者的日常透析频次与血流量比较差异无统计学意义(P>0.05)。观察组35例患者导管功能不良的原因分为栓塞性因素22例(62.86%),感染性因素8例(22.86%),机械性因素5例(14.29%)。结论随着患者透析龄的增加,导管出现功能不良的风险会增加。及时溶栓治疗与提高封管技巧可减少导管栓塞的发生率;加强导管的无菌操作与对患者的健康教育,可明显减少导管感染的发生。Objective To explore the factors relating to long-term central venous catheter dysfunction in hemodialysis patients. Methods 80 hemodialysis patients with long-term central venous catheter and treated over six months in period of January 2009 to December 2013 in our hospital were retrospectively surveyed. Patients were divided into two groups according to the presence of catheter dysfunction,45 patients with poor catheter function were observed group,35 patients without catheter dysfunction were control group. The general situation of two group patients was compared. The factors of their catheter dysfunction was investigated. Results There was no significant difference in age,gender and primary disease between the two groups（ P〉 0. 05）,but the dialysis age in observation group was significantly longer than that in control group,with a statistically significant difference（ P〈 0. 05）. There was no significant difference in the frequency of daily dialysis and blood flow between the two groups（ P 〉0. 05）. The causes of poor catheter function in 35 patients in observation group were divided into embolic factors in 22 cases（ 62. 86% in sputum）,infection in 8 cases（ 22. 86%）,and mechanical factors in 5 cases（ 14. 29%）. Conclusion With the increase of dialysis age in patients,the risk of catheter dysfunction can increase. Timely thrombolytic therapy and improve sealing catheter technique can reduce the incidence of catheter embolization. Strengthen the catheter aseptic operation and health education to patients,may reduce the incidence of catheter related infection.

关 键 词：血液透析 中心静脉长期置管 导管功能不良 

分 类 号：R692.5[医药卫生—泌尿科学]