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经皮腰椎下腔静脉置管作为血液透析的紧急通路——5年经验

Percutaneous translumbar catheterization of the inferior vena cava as an emergency access for hemodialysis - 5 years of experience.

作者信息

Kade Grzegorz, Les Jaroslaw, Buczkowska Magdalena, Łabus Malgorzata, Niemczyk Stanislaw, Wankowicz Zofia

机构信息

1 Department of Internal Medicine, Nephrology and Dialysotherapy, Military Institute of Medicine, Warsaw - Poland.

出版信息

J Vasc Access. 2014 Jul-Aug;15(4):306-10. doi: 10.5301/jva.5000185. Epub 2013 Nov 4.

Abstract

PATIENTS AND METHODS

In this study, 13 patients (11 men and 2 women) undergoing hemodialysis (HD) with the use of a catheter placed into the inferior vena cava with percutaneous translumbar access were retrospectively evaluated. In the studied group, 16 procedures of percutaneous translumbar catheterization were performed. Complications connected with the presence of catheter, such as hematoma, thrombosis, infection, catheter movement or unsuccessful catheterization, were analyzed. Moreover, another aspect of our report was to evaluate the adequacy of HD treatment performed by lumbar catheter.

RESULTS

The total time of translumbar catheter observation was 4,169 days. Average time of their functioning was 261 days. The most frequent reason for termination of the use of translumbar HD catheters was spontaneous/idiopathic removal - 2 cases. Episodes of infection and thrombosis per 1,000 days of catheter observation were 2.2 and 1.2, respectively.

CONCLUSIONS

Based on our study, we can conclude that correctly performed percutaneous translumbar catheterization of the inferior vena cava, in order to produce a long-term vascular access for HD, is a valuable and safe method in patients after depletion of standard vascular accesses.

摘要

患者与方法

在本研究中,对13例(11例男性和2例女性)使用经皮经腰穿刺将导管置入下腔静脉进行血液透析(HD)的患者进行了回顾性评估。在研究组中,共进行了16次经皮经腰导管插入术。分析了与导管存在相关的并发症,如血肿、血栓形成、感染、导管移位或导管插入失败。此外,我们报告的另一个方面是评估经腰导管进行血液透析治疗的充分性。

结果

经腰导管观察的总时间为4169天。其平均使用时间为261天。经腰血液透析导管停用的最常见原因是自发/特发性拔除——2例。每1000天导管观察的感染和血栓形成发生率分别为2.2和1.2。

结论

基于我们的研究,我们可以得出结论,为了建立长期的血液透析血管通路,正确实施的经皮经腰下腔静脉导管插入术对于标准血管通路耗竭的患者来说是一种有价值且安全的方法。

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