Motta Elias Rosilene, da Silva Makida Sonia Cristina, Abensur Hugo, Martins Castro Manuel Carlos, Affonso Moysés Rosa Maria, Pereira Benedito Jorge, Bueno de Oliveira Rodrigo, Luders Cláudio, Romão João Egidio
Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil.
J Vasc Access. 2010 Apr-Jun;11(2):138-42. doi: 10.1177/112972981001100210.
The tunneled cuffed catheter (TCC) is used as a bridge access for hemodialysis. Few prospective studies have been designed to evaluate conversion from non-tunneled to TCC without the use of fluoroscopy when performed by nephrologists.
We performed an observational prospective cohort in incident patients receiving hemodialysis through a non-tunneled right jugular vein catheter.
130 procedures were performed in 122 patients (51+/-18 years). The success rate was 100%. There was a total of 26,546 catheter days. Ninety-one of the 130 catheters were removed during the study period. Life table analysis revealed primary patency rates of 92%, 82%, and 68% at 30, 60, and 120 days, respectively. Infection requiring catheter removal occurred at a frequency of 0.09 per 100 catheter days. Catheter malfunction requiring intervention occurred at a rate of 0.03 per 100 catheter days. Hypertension and duration of existing non-tunneled catheter of less than 2 weeks were independently associated with better TCC survival.
The conversion from non-tunneled to TCC performed by nephrologists and without fluoroscopy may be safe by using the internal right jugular vein. The ideal time to do this procedure is within less than 2 weeks of existing non-tunneled catheter.
带隧道带涤纶套导管（TCC）用作血液透析的过渡通路。很少有前瞻性研究设计用于评估肾病学家在不使用荧光透视的情况下将非隧道式导管转换为TCC的情况。
我们对通过非隧道式右颈内静脉导管进行血液透析的初治患者进行了一项观察性前瞻性队列研究。
对122例患者（51±18岁）进行了130次操作。成功率为100%。导管总使用天数为26546天。在研究期间，130根导管中有91根被拔除。生命表分析显示，在30、60和120天时的初次通畅率分别为92%、82%和68%。因感染需要拔除导管的发生率为每100导管日0.09次。因导管故障需要干预的发生率为每100导管日0.03次。高血压和现有非隧道式导管使用时间少于2周与TCC更好的留存率独立相关。
肾病学家在不使用荧光透视的情况下将非隧道式导管转换为TCC，通过使用右颈内静脉可能是安全的。进行该操作的理想时间是在现有非隧道式导管使用少于2周内。
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