Kaneko Yoshikatsu, Iwano Masako, Yoshida Hitomi, Kosuge Miyoko, Ito Sanae, Narita Ichiei, Gejyo Fumitake, Suzuki Masashi
Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
Blood Purif. 2004;22(5):473-9. doi: 10.1159/000081811. Epub 2004 Oct 29.
Thrombotic occlusion is a frequent complication of central venous catheters used to provide temporary blood access on hemodialysis therapy. Heparin-lock is conventionally used to maintain patency of the catheter, but the necessity of heparin-lock has not been determined yet.
After the immobilized-urokinase double-lumen central venous catheter was inserted into 48 Japanese hemodialysis patients, 22 patients randomized to the heparin group received a 20-ml saline-flush, followed by 2 ml of 1,000 U/ml heparin-lock, and 26 patients randomized to the saline group received only the 20-ml saline-flush once a day for each lumen.
Thrombotic occlusion was observed in only 1 out of 22 patients in the heparin group and 1 out of 26 patients in the saline group. No significant difference of the catheter survival was observed between the two groups (p = 0.8599).
Natural saline-flush is sufficient for maintaining the patency of an immobilized-urokinase double-lumen central venous catheter.
血栓形成性闭塞是用于血液透析治疗中提供临时血液通路的中心静脉导管的常见并发症。传统上使用肝素封管来维持导管通畅，但肝素封管的必要性尚未确定。
将固定化尿激酶双腔中心静脉导管插入48例日本血液透析患者体内后，随机分为肝素组的22例患者接受20ml生理盐水冲洗，随后注入2ml 1000U/ml肝素封管液，随机分为生理盐水组的26例患者每个管腔每天仅接受一次20ml生理盐水冲洗。
肝素组22例患者中仅1例出现血栓形成性闭塞，生理盐水组26例患者中仅1例出现。两组导管存活情况无显著差异（p = 0.8599）。
生理盐水冲洗足以维持固定化尿激酶双腔中心静脉导管的通畅。
