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常规和反向置管的颈静脉导管中的通路再循环。

Access recirculation in jugular venous catheter in regular and reversed lines.

作者信息

Atapour Abdolamir, Mosakazemi Mahdiyesadat, Mortazavi Mojgan, Beigi Aliakbar, Shahidi Sharzad

机构信息

Division of Nephrology, Department of Internal Medicine, Noor Hospital, Isfahan University of Medical Sciences, Esfahan, Iran.

出版信息

Iran J Kidney Dis. 2008 Apr;2(2):91-4.

Abstract

INTRODUCTION

The aim of this study was to determine access recirculation in functioning catheters in the regular and reversed positions.

MATERIALS AND METHODS

Access recirculation was measured in 2 sequential hemodialysis sessions in patients with functioning internal jugular catheters inserted not earlier than 2 weeks before the study. The arterial and venous lines were in their regular position during the first session and they were reversed during the second measurement. Changes in access recirculation were assessed. Also, type of the catheter and number of catheter insertions were evaluated in relation to access recirculation.

RESULTS

Twenty-five of the patients had a permanent catheter and 5 had a temporary catheter. During the first session, the mean of access recirculation was 6.9 +/- 6.7% in the patients with a permanent catheter and 7.8 +/- 8.4% in those with a temporary catheter (P = .45). The mean access recirculation was 7.1 +/- 6.9% (range, 0 to 20%) in the 30 patients on hemodialysis with the arterial and venous lines in their regular positions. When the lines were reversed, access recirculation increased significantly (P = .01) to a mean of 20.5 +/- 20.5% (range, 2.3% to 75%). There was no significant correlation between the type of catheter or the number of catheter insertions and access recirculation.

CONCLUSIONS

After reversing the arterial and venous lines, access recirculation in both temporary and permanent functioning catheters may increase; therefore, dialysis adequacy might be impaired by reversed lines. Replacing malfunctioning catheters with new ones seems to be better than reversing the lines.

摘要

引言

本研究的目的是确定功能正常的导管在常规位置和反转位置时的通路再循环情况。

材料与方法

在研究前不早于2周插入功能正常的颈内静脉导管的患者中,在连续2次血液透析治疗过程中测量通路再循环。在第一次治疗期间,动脉和静脉管路处于常规位置,在第二次测量时将它们反转。评估通路再循环的变化。此外,还评估了导管类型和导管插入次数与通路再循环的关系。

结果

25例患者有永久性导管,5例有临时性导管。在第一次治疗期间,永久性导管患者的通路再循环平均值为6.9±6.7%,临时性导管患者为7.8±8.4%(P = 0.45)。30例血液透析患者在动脉和静脉管路处于常规位置时,通路再循环平均值为7.1±6.9%(范围为0至20%)。当管路反转时,通路再循环显著增加(P = 0.01),平均值达到20.5±20.5%(范围为2.3%至75%)。导管类型或导管插入次数与通路再循环之间无显著相关性。

结论

动脉和静脉管路反转后,临时性和永久性功能正常的导管的通路再循环均可能增加;因此,管路反转可能会损害透析充分性。用新的导管替换功能不良的导管似乎比反转管路更好。

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