血液透析中带涤纶套中心静脉留置导管的通畅率及其影响因素分析  

Analysis of Patency Rate and Its Influencing Factors of Central Venous Indwelling Catheter with Polyester Sleeve in Hemodialysis

作　　者：魏瑜双 WEI Yushuang(Dialysis Room,Zoucheng Hospital of Traditional Chinese Medicine,Zoucheng,Shandong Province,273500 China)

机构地区：[1]邹城市中医院透析室,山东邹城273500

出　　处：《中外医疗》2021年第16期166-169,共4页China & Foreign Medical Treatment

摘　　要：目的研究在进行血液透析时使用带涤纶套中心静脉留置导管的通畅率,及对其影响因素分析。方法方便选取该院2017年2月—2020年2月期间收治需要行血液透析患者152例,分为研究组(n=42,发生导管堵塞)和对照组(n=110,未发生导管堵塞),分析患者血液透析后相关指标变化,记录留置导管的通畅率,分析通畅率的主要影响因素。结果经开展导管留置质量控制改进措施后,导管通常率显著高于改进措施前,差异有统计学意义(P<0.05);研究组、对照组患者血液透析后Alb、BF、hs-CRP等血常规指标变化显著,差异有统计学意义(P<0.05);研究组患者血液透析后尿激酶封管患者比例比对照组少,导管感染患者比例比对照组多,差异有统计学意义(P<0.05);经Logistic回归分析后确定Alb、hs-CRP、尿激酶封管、导管感染是影响导管通畅率的主要影响因素(OR=0.939,t=5.381,P<0.05;OR=2.317,t=7.044,P<0.01;OR=0.572,χ^(2)=5.676,P<0.05;OR=2.403,χ^(2)=9.513,P<0.01),hs-CRP、导管感染是导管通畅率的独立影响因素(OR=2.317,t=7.044,P<0.01;OR=2.403,χ^(2)=9.513,P<0.01)。结论控制患者炎症反应,降低患者的hs-CRP水平,并使用生物相容性较好的透析膜,必要时采用尿激酶封管,并加强患者营养水平,提高患者抵抗力,能有效降低留置导管血栓。Objective To study the patency rate of using polyester sheathed central venous indwelling catheter during hemodialysis and analysis of its influencing factors.Methods From February 2017 to February 2020,convenient 152 patients requiring hemodialysis were selected and divided into study group(n=42,catheter blockage occurred)and control group(n=110,no catheter blockage occurred).Analyzed the changes in related indicators of patients after hemodialysis,recorded the patency rate of the indwelling catheter,and analyzed the main influencing factors of the patency rate.Results After the improvement measures for quality control of catheter indwelling were carried out,the usual rate of catheters was significantly higher than before the improvement measures,and the difference was statistically significant(P<0.05);the blood routine indexes such as Alb,BF,hs-CRP,etc.of the study group and control group changed significantly after hemodialysis.The difference between groups was statistically significant(P<0.05);in the study group after hemodialysis the proportion of patients with urokinase lock tube was less than that of the control group,and the proportion of patients with catheter infection was more than that of the control group.The difference between groups was statistically significant(P<0.05);after Logistic regression analysis,it is determined that Alb,hs-CRP,urokinase tube lock,and catheter infection were the main factors affecting the catheter patency rate(OR=0.939,t=5.381,P<0.05;OR=2.317,t=7.044,P<0.01;OR=0.572,χ^(2)=5.676,P<0.05;OR=2.403,χ^(2)=9.513,P<0.01),hs-CRP and catheter infection were independent influencing factors of catheter patency(OR=2.317,t=7.044,P<0.01;OR=2.403,χ^(2)=9.513,P<0.01).Conclusion To control the patient's inflammatory reaction,reduce the patient's hsCRP level,and use a dialysis membrane with better biocompatibility,seal the tube with urokinase if necessary,strengthen the patient's nutritional level,improve the patient's resistance,and effectively reduce the indwelling catheter thrombosis.

关 键 词：血液透析 带涤纶套中心静脉留置导管 通畅率 

分 类 号：R47[医药卫生—护理学]