| 摘要: |
| 目的探讨经颈内静脉原位导丝法换置中心静脉长期血液透析导管在维持性血液透析（MHD）患者中的应用价值。方法选取近3年在颈内静脉留置的中心静脉长期血液透析导管因功能障碍后，并经颈内静脉原位导丝法换置长期导管，术后及每次透析后均改用尿激酶封管患者16例（原位换置组）；选取同期首次经颈内静脉留置中心静脉长期血液透析导管,普通肝素封管患者20例作为对照组；分析两组患者围术期泵控血流量及随访期的反应及开存期率、次开存期率。结果围术期泵控血流量原位换置组高于对照组，有统计学差异（P＜0.05）；两组比较感染例次/1000导管日0.9%与1.0%，无统计学差异（P＞0.05）。原位换置组围术期未发生中重度并发症，12个月开存期率81.2%、次开存期率93.8%；对照组开存期率为65%、次开存期率85%；两组比较无统计学差异（P＞0.05）。结论颈内静脉原位导丝法换置中心静脉长期血液透析导管，在MHD患者中的使用是安全的、可行的。 |
| 关键词: 颈内静脉 导丝法换置 中心静脉长期导管 血液透析 |
| DOI： |
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| In situ displacement of central venous catheter with internal jugular vein guide wire in patients with maintenance hemodialysis |
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He Yuanjun, Jin Jie, Jiang Guoxia
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Zhejiang Quhua Hospital
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| Abstract: |
| Objective To assess the application of in situ displacement of central venous catheter with internal jugular vein guide wire in patients with maintenance hemodialysis (MHD). Methods Central venous hemodialysis catheter was displaced with internal jugular vein guide wire in 16 MHD patients and the tube was sealed with urokinase after dialysis; at the same time, 20 MHD patients with long-term central venous catheter using heparin tube sealing was randomly selected as control group. The performance was analyzed and compared between two groups. Results The perioperative blood flow in replacement group was higher than that in control group(P＜0.05). The 12-month catheter open rate and time catheter open rate in replacement group and control group was 81.2%, 65% and 93.8%, 85% respectively(both P ＞0.05). The infection rates in two groups were 0.9% and 1.0%, (字2=0.79, P ＞0.05). Conclusion The internal jugular vein in situ guide wire hypallage of central venous catheter is safe and feasible for patients with MHD. |
| Key words: The internal jugular vein Guide wire displacement Long-term central venous catheter Hemodialysis |
