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一种新型带袖套聚氨酯中心静脉导管经皮插入及长期使用的临床评估

Clinical evaluation of percutaneous insertion and long-term usage of a new cuffed polyurethane catheter for central venous access.

作者信息

Moran B J, Sutton G L, Karran S J

机构信息

University Surgical Unit, Southampton General Hospital.

出版信息

Ann R Coll Surg Engl. 1992 Nov;74(6):426-9.

Abstract

A new, long-term venous access catheter was evaluated in clinical practice and the insertion time, complication rate and prospective follow-up recorded. Fifty novel polyurethane catheters (Cuff-Cath) were inserted in 48 patients, for cytotoxic chemotherapy in 36, long-term total parenteral nutrition in five and miscellaneous indications in seven. All catheters were inserted by a percutaneous technique under local anaesthesia. The mean insertion time was 18 min. There were three insertion complications; failure to cannulate, pneumothorax and malposition. Seven catheters required removal (sepsis in five, subclavian vein thrombosis in two) and one catheter fell out. Total catheter days to date has been 6607 (mean 132, range 18-831 days). Eleven catheters are still in use a mean of 154 days (range 38-490 days) after insertion. Furthermore, a new technique has been described which prevents inadvertent displacement. This new catheter combines the mechanical advantages of polyurethane, together with those of a Dacron cuff. Early results suggest that this catheter may be a useful alternative to silicone catheters of the Hickman/Broviac type for long-term central venous access.

摘要

一种新型长期静脉通路导管在临床实践中进行了评估,并记录了插入时间、并发症发生率和前瞻性随访情况。在48例患者中插入了50根新型聚氨酯导管(袖带导管),其中36例用于细胞毒性化疗,5例用于长期全胃肠外营养,7例用于其他各种适应证。所有导管均在局部麻醉下采用经皮技术插入。平均插入时间为18分钟。有3例插入并发症,即插管失败、气胸和位置不当。7根导管需要拔除(5例因败血症,2例因锁骨下静脉血栓形成),1根导管脱落。迄今为止,导管总使用天数为6607天(平均132天,范围18 - 831天)。11根导管仍在使用,插入后平均使用154天(范围38 - 490天)。此外,还描述了一种防止意外移位的新技术。这种新导管结合了聚氨酯的机械优势以及涤纶袖带的优势。早期结果表明,对于长期中心静脉通路,这种导管可能是希克曼/布罗维阿克型硅胶导管的一种有用替代品。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/09cc/2497711/8b8fdbfaf313/annrcse01577-0061-a.jpg

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