带cuff血液透析导管颈内静脉长期留置临床分析胡军建,徐建华,任月运,杨靖(徐州市肿瘤医院肾内科,江苏徐州221005)摘要:目的总结分析维持性血液透析(血透)患者颈内静脉长期留置带cuff血透导管相关资料,以期更好保护导管,延长使用寿命。方法选择维持性血透患者56例,长期留置带cuff血透导管,观察并记录一般实验室检查、血压、肾衰竭病因、置入带cuff长期导管的原因、导管类型、手术入路、导管相关并发症(感染、血栓形成等)、导管使用寿命及退出原因。结果现阶段应用带cuff血透导管作为血管通路者21例,占同期透析患者的19.23%。最长使用时间37.6个月,平均时间(32.2±3.2)个月。血流量200~300ml/min。并发症情况:出口感染2例,导管相关菌血症9例,导管扭曲、位置不适当2例,血栓性并发症8例,导管完全脱出1例,部分脱出1例。所有并发症均进行适当治疗。结论带cuff血透导管作为长期血管通路使用安全有效,可以作为等待动静脉内瘘成熟期间较理想的过渡通路。规范化管理、预防和治疗并发症是留置带cuff血透导管管理的重点。关键词:血液透析;带涤纶环血透导管;并发症中图分类号:R459.5文献标志码:A文章编号:1000-2065(2011)12-0809-04Theretrospectiveanalysisofindwellingvenoustunneledcuffedcathetersforpermanentusein56maintenancehemodialysispatientsHUJunjian,XUJianhua,RENYueyun,YANGJing(DepartmentofNephrology,XuzhouCancerHospital,Xuzhou,Jiangsu221005,China)Abstract:ObjectiveToreviewandanalyzetherelatedinformationof56maintenancehemodialysispatientswithinternaljugularveinlong-termindwellingcatheterwithcuff,soastobetterprotectlong-termcatheterandprolongservicelife.Methods56patientsundergoingmaintenancehemodialysiswithlong-termindwellingcatheterwithcuff,wererecruitedinthestudytoobserveandrecordgenerallaboratory,bloodpressure,kidneyfailurereason,thecauseofindwellingcatheterwithcuff,cathetertype,surgicalapproach,catheterrelatedcomplications(infection,thrombosis,etc),catheterservicelifeandtheexitreasons.ResultsAtpresentapplicationtunneledcuffedcatheterforhemodialysisas21cases,accountingforthesameperioddialysiscentersofdialysispatients19.23%.Thelongestusetimewas37.6months,theaveragetimewas(32.2±3.2)months.Theflowofbloodwas200-300ml/min.Complicationssituation:includingexportinfectionin2cases,catheter-relatedbacteraemiain9cases,catheterdistortionandpositionwasnotap-propriate2cases,thrombosis8casesofcomplications,cathet...