多排螺旋计算机断层血管造影术在评估带隧道的血液透析中心静脉导管功能障碍中的应用
Multi-detector computed tomography venography in the assessment of dysfunction of tunneled hemodialysis central vein catheters.
作者信息
Cui Tianlei, Li Zhenlin, Yang Yingying, Zeng Xiaoxi, Zhou Li, Jin Lizhu, Su Baihai, Tao Ye, Fu Ping
机构信息
Department of Nephrology, West China Hospital of Sichuan University, P. R. China.
出版信息
J Vasc Access. 2012 Jul-Sep;13(3):388-92. doi: 10.5301/jva.5000067.
PURPOSE
To assess the value of multi-detector computed tomography venography (MDCTV) in the assessment of tunneled hemodialysis central vein catheters (CVCs) dysfunction.
METHODS
Twenty-five patients who had tunneled CVC dysfunction without abnormality found by x-ray and ultrasound were enrolled. Anti-platelet agents, anticoagulants, and thrombolytic therapy with urokinase failed to resume normal catheter function. MDCTV was performed to observe the position of catheters and to detect central venous stenosis, thrombosis, and fibrin sheath formation. Correct intervention was given according to MDCTV results.
RESULTS
MDCTV revealed that the catheter was malpositioned in 10 cases; there were five cases of central venous stenosis, four cases of central venous thrombosis, one case of fibrin sheath formation, and the other five had no abnormalities found. Blood flow on hemodialysis had reached over 300 mL/min after correct intervention.
CONCLUSIONS
MDCTV provided a new possible way to assess dysfunction of tunneled hemodialysis central venous catheters.
目的
评估多排螺旋CT静脉成像（MDCTV）在评估带隧道的血液透析中心静脉导管（CVC）功能障碍方面的价值。
方法
纳入25例带隧道CVC功能障碍患者，这些患者经X线和超声检查未发现异常。使用抗血小板药物、抗凝剂以及尿激酶溶栓治疗均未能恢复导管正常功能。进行MDCTV检查以观察导管位置，并检测中心静脉狭窄、血栓形成和纤维蛋白鞘形成情况。根据MDCTV结果给予正确干预。
结果
MDCTV显示，10例导管位置不当；5例中心静脉狭窄，4例中心静脉血栓形成，1例纤维蛋白鞘形成，其余5例未发现异常。正确干预后血液透析血流量达到300 mL/min以上。
结论
MDCTV为评估带隧道的血液透析中心静脉导管功能障碍提供了一种新的可能方法。
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