长期深静脉置管在血液透析患者中的应用观察  

Observation on Long-Term Deep Vein Catheterization in Hemodialysis Patients

作　　者：朱晓红[1] 姜莉[1] 郭刚[1] 姜江 ZHU Xiaohong;JIANG Li;GUO Gang;JIANG Jiang(Hemodialysis Room,Qianjiang Central Hospital,Qianjiang Hubei 433100,China;Department of Nephrology,Qianjiang Central Hospital,Qianjiang Hubei 433100,China)

机构地区：[1]潜江市中心医院血液透析室,湖北潜江433100 [2]潜江市中心医院肾内科,湖北潜江433100

出　　处：《中国卫生标准管理》2023年第21期179-182,共4页China Health Standard Management

基　　金：湖北省自然科学基金项目(JAT20022675)。

摘　　要：目的探讨长期深静脉置管在血液透析患者中的应用。方法选取2021年9月—2022年9月潜江市中心医院收治的血液透析患者116例,通过置管方式不同将其分为两组,导管组进行导管透析,内瘘组进行内瘘透析。比较两组的一般资料、营养指标情况、透析效能情况、微炎症指标情况、并发症情况。结果内瘘组左心室EP、血流量、通路使用时间大于导管组(P<0.05)。两组低密度脂蛋白、高密度脂蛋白、三酰甘油、总胆固醇、白蛋白、血红蛋白等各项营养指标相比,差异无统计学意义(P>0.05);两组蛋白分解率、尿素氮下降率、尿素氮清除率、尿酸、肌酐、尿素氮等透析效能相比,差异无统计学意义(P>0.05);内瘘组超敏C-反应蛋白(high-sensitivity C-reactive protein,hs-CRP)、白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-1(tumor necrosis factor-1,TNF-1)等微炎症指标低于导管组(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论长期深静脉置管在血液透析患者中,导管透析与内瘘透析的营养状况、透析效能相比基本相同,且不会增加并发症的发生率,,但是依然可以作为血液透析患者建立血液透析通路的较好代替。Objective To explore the application of long-term deep vein catheterization in hemodialysis patients.Methods A total of 116 hemodialysis patients admitted to Qianjiang Central Hospital from September 2021 to September 2022 were selected and divided into two groups based on different catheterization methods.The catheterization group received catheterization dialysis,while the internal fistula group received internal fistula dialysis.Compare the general information,nutritional indicators,dialysis efficiency,micro inflammatory indicators,and complications between the two groups.Results Left ventricular EP,blood flow,and access time in the internal fistula group were greater than those in the catheter group(P<0.05).Nutritional indicators such as low-density lipoprotein,high-density lipoprotein,triglyceride,total cholesterol,albumin,and hemoglobin in the two groups had no significant difference(P>0.05).There was no significant difference in the dialysis efficiency of the two groups(P>0.05).Fistula group high-sensitivity C-reactive protein(high-sensitivity C-reactive protein,hs-CRP),interleukin-6(interleukin-6,IL-6),tumor necrosis factor-1(tumor necrosis factor-1,TNF-1)and other micro-inflammatory indicators were lower than those in the catheter group(P<0.05).Comparison of complication rates between the two groups,the difference was not statistically significant(P>0.05).Conclusion In hemodialysis patients with long-term deep vein catheterization,the nutritional status and dialysis efficacy of catheter dialysis are basically the same as that of internal fistula dialysis,and does not increase the incidence of complications,which can still be a good substitute for establishing hemodialysis access in hemodialysis patients.

关 键 词：长期深静脉置管 导管透析 内瘘透析 血液透析 营养状况 透析效能 并发症 

分 类 号：R692[医药卫生—泌尿科学]