[带隧道的血液透析导管作为永久性血管通路的结局]

[Outcome of tunneled hemodialysis catheters as permanent vascular access].

作者信息

Hernández-Jaras J, García-Pérez H, Torregrosa E, Pons R, Calvo C, Serra M, Orts M, Ríus A, Camacho G, Bernat A, Sánchez-Canel J J

机构信息

Servicio de Nefrología, Hospital General de Castellón, Centro de Diálisis Gambro HealthCare.

出版信息

Nefrologia. 2004;24(5):446-52.

PMID:15648902

Abstract

UNLABELLED

Tunneled cuffed hemodialysis catheters (THC) are developed as a means of short hemodialysis access while a more permanent form of access are maturing. The aim of this study is to investigate the effectiveness, survival and complications of the THC used for long-term vascular access.

METHODS

In a retrospective study we looked at 42 THC inserted between November 2000 and October 2003, in 40 elderly patients, with systemic disease or when other vascular access was not possible.

RESULTS

Procedural complications occurred in 5 cases (11.9%), which included: local haemorrhage (3), hemothorax (1) and one fatal venous tear. 6 catheters (14.2%) were removed due to complications (non-function 3 and bacteraemia 3). The total incidence of THC related infections was 0.18 episodes/1,000 catheters-days. Patients were followed up for a mean 379 days (range 1-1,140) and a total of 15,946 catheter-days. Qb and KT/V achieved at one month were 278.3 +/- 34.1 ml/min and 1.48 +/- 0.27 respectively. At the end of the follow-up, 23 patients (54.7%) were alive with catheter functioning. One, three and twelve months survival was 90.4%, 73.1% and 59.5% respectively.

CONCLUSION

The THC may be a useful alternative permanent vascular access for hemodialysis patients when others vascular access are not possible.

摘要

未标注

隧道式带 cuff 血液透析导管（THC）是在更永久性的血管通路成熟之前，作为一种短期血液透析通路的方式而开发的。本研究的目的是调查用于长期血管通路的 THC 的有效性、生存率和并发症。

方法

在一项回顾性研究中，我们观察了 2000 年 11 月至 2003 年 10 月期间，在 40 例老年患者中插入的 42 根 THC，这些患者患有全身性疾病或无法采用其他血管通路。

结果

5 例（11.9%）发生了操作并发症，包括：局部出血（3 例）、血胸（1 例）和 1 例致命的静脉撕裂。6 根导管（14.2%）因并发症（功能障碍 3 例和菌血症 3 例）被拔除。THC 相关感染的总发生率为 0.18 次/1000 导管日。患者平均随访 379 天（范围 1 - 1140 天），总导管日数为 15946 天。1 个月时达到的血流量（Qb）和尿素清除指数（KT/V）分别为 278.3±34.1 ml/min 和 1.48±0.27。随访结束时，23 例患者（54.7%）存活且导管功能良好。1 个月、3 个月和 12 个月的生存率分别为 90.4%、73.1%和 59.5%。