Application of long-term cuffed catheter in patients with chronic hemodialysis
10.3760/cma.j.issn.1008-6315.2010.01.021
- VernacularTitle:涤纶环深静脉留置导管在血液透析中的应用
- Author:
Hengjin WANG
;
Miao ZHANG
;
Chen SUN
;
Chunming JIANG
;
Shu RONG
;
Hai GE
- Publication Type:Journal Article
- Keywords:
Hemodialysis;
Catheters;
Deep vein
- From:
Clinical Medicine of China
2010;26(1):50-53
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the technique and effect of tunneled cuffed catheter as long-term hemodialysis access and the prevention of its related complications.Methods Permcath cuffed dual lumen catheter wag implanted in patients by the standard Seldinger technique,that a guidewire wss inserted into deep central vein, following by the insertion of the cuffed catheter through a peel-away sheath.The catheter related complications were observed.Urea reduce rate(URR),the Kt/V,the normalized protein catabolic rate(nPCR)and the time-averaged BUN concentration(TACurea)were measured as the index of the effect of hemodislysis.The effects were compared to those of arteriovenous fistula(AVF)within the same period(in 20 cases).Results In the total of 25 patients, 23 catheters were implanted in the internal jugular vein (21 cases at right,two at left side),one in the subclavian vein and one in the external jugular vein.Except for that one case died of cerebral infarction,all patients were using the catheter in well condition.Catheter related thrombosis or underfed occurred in 4 cases for 9 times, which became fluent after thrombolytic therapy or the adjustment of catheters.Catheter related infections occurred in 2 cases,and were successfully treated with anti-inflammation therapy.The average URR was 71.03%,Kt/V was 1.29,TAC urea was 12.74 mmol/L,and nPCR was 0.93 g/(kg·d)in all 25 patients,which was not significant different compared to patients with AVF((URR 72.46%,Kt/V 1.31,TACurea 12.86 mmol/L,nPCR 0.94 g/(kg·d)).Conclusions Cuffed dual lumen catheter for long-term aecegs in persistent hemodialysis has good effect on hemodialysis. Good catheter implanting technique and prevention of complications may improve the application of the catheter.
