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中心静脉导管作为血液透析的血管通路——我们的经验

Central venous catheter as vascular approach for hemodialysis - our experiences.

作者信息

Misanovic Verica, Jonuzi Fedzat, Anic Dusko, Halimic Mirza, Rahmanovic Samra

机构信息

Pediatric Clinic, Clinical Center, University of Sarajevo, Sarajevo, Bosnia and Herzegovina.

出版信息

Mater Sociomed. 2015 Apr;27(2):112-3. doi: 10.5455/msm.2015.27.112-113. Epub 2015 Apr 5.

Abstract

INTRODUCTION

Application of a central venous catheter (CVC), as a temporary or permanent vascular access for hemodialysis, has been continuous practice at the Sarajevo Pediatric Clinic, Department of Pediatric Intensive Care. The main goal of the article is to present our experiences with central venous catheters in the treatment of these patients.

MATERIAL AND METHODS

In the period from January 2009 to December 2014 a total of 41 patients were treated and a total of 56 catheters were placed.

RESULTS

The results show the prevalence of the femoral venous catheter (69,64%), with significantly smaller participation of jugular (28,57%) and symbolic participation of subclavian catheters (1,78%). Frequency of infections of 8,92% in our article is lower than the percentage contained in the data of the National Nosocomial Infections Surveillance System, which provided data related to 17% of catheter related infections. The most common agents of the catheter related infections in our patients are gram-negative bacteria from the Klebsiella pneumoniae group.

CONCLUSION

The issue of the higher complication percentage during the treatment is linked with hemostasis related to bleeding into or around the catheters in 28,57% of patients, and to clotting disorder in terms of thrombosis in 10,71% of patients.

摘要

引言

中心静脉导管(CVC)作为血液透析的临时或永久性血管通路,在萨拉热窝儿科诊所小儿重症监护科一直被持续应用。本文的主要目的是介绍我们在这些患者治疗中使用中心静脉导管的经验。

材料与方法

在2009年1月至2014年12月期间,共治疗了41例患者,共置入了56根导管。

结果

结果显示股静脉导管的使用率最高(69.64%),颈内静脉导管的使用率显著较低(28.57%),锁骨下导管的使用率很低(1.78%)。我们文章中8.92%的感染率低于国家医院感染监测系统数据中的百分比,该系统提供的与导管相关感染的数据为17%。我们患者中导管相关感染最常见的病原体是肺炎克雷伯菌属的革兰氏阴性菌。

结论

治疗期间较高并发症发生率的问题与28.57%的患者导管内或导管周围出血的止血有关,以及与10.71%的患者血栓形成方面的凝血障碍有关。

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