血液透析导管致上腔静脉闭塞引起低血压1例并文献复习  

Hypotension in a hemodialysis patient with catheter-induced superior vena cava stenosis:a case report and literature review

作　　者：徐成亮 崔天蕾[1] Xu Chengliang;Cui Tianlei(Department of Nephrology,West China Hospital of Sichuan University,Chengdu 610041,China;Department of Nephrology of Wuwei People's Hospital,Wuwei 733000,China)

机构地区：[1]四川大学华西医院肾内科,成都610041 [2]武威市人民医院肾内科,武威733000

出　　处：《中华肾脏病杂志》2024年第12期961-964,共4页Chinese Journal of Nephrology

基　　金：武威市科技计划项目(WW23B02SF041)。

摘　　要：该文报道1例血液透析导管致上腔静脉闭塞引发低血压病例。患者女,65岁,接受维持性血液透析治疗3年,因透析中出现不能耐受的低血压就诊,透析通路为带隧道和涤纶套的中心静脉导管。计算机断层血管造影和数字减影血管造影检查发现上腔静脉与右心房交界处闭塞。经腔内治疗开通上腔静脉后,患者血压恢复正常,能耐受4 h的常规血液透析。复习相关文献,上腔静脉闭塞是引起维持性血液透析患者低血压的原因之一,腔内治疗开通闭塞的上腔静脉可有效纠正此类低血压。This paper reports a case of hypotension caused by superior vena cava stenosis due to hemodialysis catheter.A 65-year-old female maintenance hemodialysis patient presented with intolerable hypotension during dialysis.The dialysis access was tunnel-cuffed catheter.Computed tomography angiography and digital subtraction angiography revealed occlusion at the junction of the superior vena cava and the right atrium.After the superior vena cava was opened by endovascular treatment,the patient's blood pressure returned to normal and could tolerate 4 hours of regular hemodialysis.Reviewing relevant literature,occlusion of superior vena cava is one of the causes of hypotension in maintenance hemodialysis patients,and endovascular treatment to open the occluded superior vena cava can effectively correct this kind of hypotension.

关 键 词：肾透析 上腔静脉综合征 低血压 

分 类 号：R692.5[医药卫生—泌尿科学]