Bourquia A, Jabrane A J, Ramdani B, Zaid D
Service de Néphrologie/Hémodialyse, CHU Ibn Rochd, Casablanca, Maroc.
Ann Med Interne (Paris). 1989;140(2):102-5.
The authors report their experience of subclavian vein catheterisation and compare their results with those of previously reported series. One hundred and sixty-four subclavian catheters were inserted in 111 patients, 66 with acute renal failure and 49 with chronic renal failure. The total number of hemodialysis sessions was 984. The catheters were left in situ for an average of 14.5 +/- 2 days or 19 +/- 2 patient days. The main immediate complications were pneumothorax (1 case) and subclavian artery puncture (2 cases). Seventeen catheters were complicated by septicemia with one fatal outcome. In addition, 5 cases of subclavian vein thrombosis, diagnosed clinically and confirmed by venography, were observed. Percutaneous subclavian vein catheterisation is a useful technique for emergency renal dialysis. However, septic and thrombotic complications are fairly frequent and potentially serious. Although measures can be taken to reduce the risk of infection, the prevention of thrombosis seems to be more difficult.
作者报告了他们进行锁骨下静脉置管的经验，并将其结果与先前报道系列的结果进行了比较。111例患者共插入了164根锁骨下导管，其中66例为急性肾衰竭患者，49例为慢性肾衰竭患者。血液透析总疗程为984次。导管平均留置14.5±2天或19±2患者日。主要的即刻并发症为气胸（1例）和锁骨下动脉穿刺（2例）。17根导管并发败血症，1例死亡。此外，观察到5例锁骨下静脉血栓形成，经临床诊断并经静脉造影证实。经皮锁骨下静脉置管是紧急肾脏透析的一种有用技术。然而，感染性和血栓性并发症相当常见且可能很严重。虽然可以采取措施降低感染风险，但预防血栓形成似乎更困难。
