Szekely J, Rácz L, Karátson A
Orv Hetil. 1989 Jan 29;130(5):239-42.
Hemodialysis was performed in 349 cases on 35 patients with 50 special subclavian catheters. The catheters were inserted infraclavicularly with Seldinger's technique. The cannulation period was 26.6 (1-148) days and on the average 7 hemodialyses (1-63) were performed through 1 catheter. The aspects of subclavian catheterization, indication and complications are described. In 3 patients suffering from chronic uremia the end of the catheter (3-5 cm) in the subclavian vein was found broken after 1-5-6 weeks long "single-needle" dialysis. The broken end became fixed into the segmental artery of the lung and did not cause any complication during the long (6-14-33 months) observation period, thus its open or transluminal removal was not considered necessary. In the opinion of the authors the "single-needle" hemodialysis should be avoided to prevent similar complications. The use of the "two-needle" treatment or a catheter with double lumen is advisable.
对35例患者的50根特殊锁骨下导管进行了349次血液透析。采用Seldinger技术在锁骨下插入导管。置管时间为26.6(1 - 148)天,平均每根导管进行7次血液透析(1 - 63次)。描述了锁骨下置管的相关情况、适应证及并发症。3例慢性尿毒症患者在进行1 - 5 - 6周的“单针”透析后,发现锁骨下静脉内的导管末端(3 - 5厘米)断裂。断裂端固定在肺段动脉中,在长达6 - 14 - 33个月的观察期内未引起任何并发症,因此认为无需进行开放或腔内取出。作者认为应避免“单针”血液透析以预防类似并发症。建议采用“双针”治疗或使用双腔导管。