Salgado Octavio J, Chacón Rosa E, Mora Edunice, Mora-LaCruz Eduardo
Center of Experimental Surgery and Medicine, University of Zulia, Maracaibo, Venezuela.
Ther Apher Dial. 2007 Oct;11(5):396-401. doi: 10.1111/j.1744-9987.2007.00502.x.
Central vein occlusion (CVO) is not uncommonly observed after hemodialysis (HD) catheter placement and it may prevent subsequent ipsilateral arteriovenous (AV) access creation. Right internal jugular vein catheterization (RJVC) appears to be the insertion site with the lowest incidence of CVO, but little is known about the incidence of CVO following left internal jugular vein catheterization (LJVC). We report on four patients with left innominate vein occlusion after LJVC who developed severe arm swelling after ipsilateral AV access creation. In three of the four cases swelling appeared 12-26 months after access creation, and in the fourth, swelling developed immediately after surgery while the catheter was still in place. Two patients underwent access ligation and in the remainder the arm swelling improved either spontaneously or after LJVC removal. LJVC is not as safe as RJVC as an insertion route for HD catheter placement in terms of CVO frequency.
中心静脉闭塞（CVO）在血液透析（HD）导管置入后并不少见，它可能会妨碍随后同侧动静脉（AV）通路的建立。右颈内静脉置管（RJVC）似乎是CVO发生率最低的置管部位，但关于左颈内静脉置管（LJVC）后CVO的发生率知之甚少。我们报告了4例LJVC后发生左无名静脉闭塞的患者，他们在同侧AV通路建立后出现了严重的手臂肿胀。4例中有3例在通路建立后12 - 26个月出现肿胀，第4例在手术时导管仍在位的情况下立即出现肿胀。2例患者接受了通路结扎，其余患者的手臂肿胀在LJVC拔除后自发缓解或有所改善。就CVO发生频率而言，LJVC作为HD导管置入的置管途径不如RJVC安全。
