Department of Radiology, Division of Interventional Radiology, University of Pennsylvania Medical Center, 1 Silverstein, 3400 Spruce St, Philadelphia, PA 19104, USA.
J Vasc Interv Radiol. 2010 Feb;21(2):203-11. doi: 10.1016/j.jvir.2009.10.020. Epub 2009 Dec 24.
To determine if a polyester cuff offered benefit in jugular small-bore central catheters (SBCCs).
Eighty-four patients were randomly assigned to receive a 5-F single- or 6-F dual-lumen SBCC with (n = 42) or without (n = 42) a polyester cuff. Follow-up was performed at 2 weeks, 1 month, and 3 months or at catheter removal, whichever came first. At scheduled follow-up, catheter function, patient satisfaction, and infection were determined. At catheter removal, tip culture was performed to determine colonization and jugular vein patency was determined with ultrasonography (US).
The overall infection rate was 0.4 per 1,000 catheter days. There was one clinical infection (noncuffed catheter). Colonization occurred in two noncuffed catheters and one cuffed catheter. There was one catheter dislodgment in the noncuffed group and none in the cuffed group. Cuffed catheters were no more difficult to insert but took slightly longer to remove (6 minutes +/- 4.7 vs 5 minutes +/- 3, P = .39) and often required local anesthesia for removal, whereas noncuffed catheters did not (41% vs 0%, P = .001). Partial (two cuffed, 0 noncuffed) or complete (two cuffed, one noncuffed) jugular thrombosis was seen on five of 58 completion US studies (8.6%).
A polyester cuff on a SBCC confers no significant benefit in short-term colonization rates. Infection in SBCCs is uncommon. Despite their small diameters, SBCCs can result in jugular thrombosis, an important consideration in any patient requiring long-term venous access.
确定聚酯袖口是否有益于颈内小口径中央导管（SBCC）。
84 名患者随机分为接受 5-F 单腔或 6-F 双腔 SBCC 组（n = 42）和无聚酯袖口 SBCC 组（n = 42）。在 2 周、1 个月和 3 个月时进行随访，或者在导管拔除时进行随访，以先到者为准。在预定的随访中，评估导管功能、患者满意度和感染情况。在导管拔除时，进行尖端培养以确定定植情况，并通过超声（US）确定颈内静脉通畅情况。
总的感染率为每 1000 导管日 0.4 例。有一例临床感染（无袖套导管）。非袖套导管中有两例定植，袖套导管中有一例定植。非袖套导管组有一例导管脱位，袖套导管组无导管脱位。袖套导管的插入并不困难，但取出时间略长（6 分钟 +/- 4.7 与 5 分钟 +/- 3，P =.39），并且通常需要局部麻醉才能取出，而非袖套导管不需要（41%与 0%，P =.001）。58 例完成的 US 研究中有 5 例（8.6%）出现部分（两个袖套，0 个无袖套）或完全（两个袖套，一个无袖套）颈内静脉血栓形成。
SBCC 上的聚酯袖口并不能显著降低短期定植率。SBCC 感染并不常见。尽管 SBCC 直径较小，但仍可能导致颈内静脉血栓形成，这在任何需要长期静脉通路的患者中都需要考虑。
