Teichgräber Ulf Karl-Martin, de Bucourt Maximilian, Gebauer Bernhard, Streitparth Florian, Hamm Bernd, Enzweiler Christian
Department of Radiology, Charité University Medicine, Berlin, Germany.
J Vasc Access. 2011 Jan-Mar;12(1):17-20. doi: 10.5301/jva.2010.6089.
A prospective, randomized-controlled trail was conducted to evaluate the effectiveness of securing tunneled hemodialysis (HD) catheters with sutureless StatLock attachment devices (Bard Access Systems) compared to traditional suture fixation.
At a university teaching hospital 72 patients with chronic renal failure received cuffed tunneled HD catheters. In the study group (n=36) the HD catheters were secured with a sutureless StatLock attachment device, whereas the control group HD catheters were fixated with sutures only. The intended intermediate use of the tunneled HD catheters was 42 ± 7 days until the arteriovenous fistula was sufficient. All catheters were placed by an interventional radiologist using ultrasound for the puncture of the internal jugular vein. We evaluated the success and complication rate of tunneled catheter implantation.
The primary success rate for implantation of HD catheters was 100%. There was an overall complication rate of 8.3% in the study group (one hematoma in the subcutaneous catheter tract and two central venous thromboses). In the control group the overall complication rate was 13.9% (two hematomas, one central venous thrombosis and two catheter displacements). The two catheter displacements required a HD catheter exchange. In addition, four local irritations at the HD catheter entry site were seen only in the control group and were rated as minor complications.
The sutureless placement technique is safe and effective with a low complication rate, and is superior to the traditional suture fixation of tunneled catheters.
进行一项前瞻性随机对照试验，以评估与传统缝线固定相比，使用无缝合StatLock固定装置（巴德接入系统）固定隧道式血液透析（HD）导管的有效性。
在一所大学教学医院，72例慢性肾衰竭患者接受了带 cuff 的隧道式 HD 导管。研究组（n = 36）使用无缝合 StatLock 固定装置固定 HD 导管，而对照组 HD 导管仅用缝线固定。隧道式 HD 导管的预期中间使用时间为42±7天，直至动静脉内瘘足够成熟。所有导管均由介入放射科医生使用超声引导穿刺颈内静脉置入。我们评估了隧道式导管植入的成功率和并发症发生率。
HD 导管植入的主要成功率为100%。研究组的总体并发症发生率为8.3%（皮下导管通道处1例血肿和2例中心静脉血栓形成）。对照组的总体并发症发生率为13.9%（2例血肿、1例中心静脉血栓形成和2例导管移位）。2例导管移位需要更换 HD 导管。此外，仅在对照组中观察到 HD 导管入口处有4例局部刺激，被评为轻微并发症。
无缝合放置技术安全有效，并发症发生率低，优于传统的隧道式导管缝线固定。
