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血液透析导管相关中心静脉血栓形成:评估与管理的临床方法

Hemodialysis Catheter-Related Central Venous Thrombosis: Clinical Approach to Evaluation and Management.

作者信息

Gunawansa Nalaka, Sudusinghe Dinesha Himali, Wijayaratne Dilushi Rowena

机构信息

National Institute of Nephrology Dialysis and Transplantation, National Hospital of Sri Lanka, Colombo, Sri Lanka; University of Liverpool, Liverpool, United Kingdom.

Nephrology, Dialysis and Transplant Unit, National Hospital of Sri Lanka, Colombo, Sri Lanka; University of Sri Jayewardenepura, Nugegoda, Sri Lanka.

出版信息

Ann Vasc Surg. 2018 Aug;51:298-305. doi: 10.1016/j.avsg.2018.02.033. Epub 2018 May 29.

Abstract

Central venous catheter (CVC) use is common among patients undergoing hemodialysis. Catheter-related vascular thrombosis is a frequent complication, which results in catheter dysfunction. This may eliminate the affected vein as a potential route of vascular access and leads to significant morbidity of the limbs involved. Despite increasing prevalence, there is a dearth of evidence-based guidelines for managing such catheter-related thrombi, often leading to treatment dilemmas in clinical practice. Minimizing the use of CVCs for hemodialysis remains the best approach in preventing such adverse complications. Furthermore, meticulous planning and care when using such catheters in unavoidable circumstances along with vigilant surveillance to identify complications early will allow to avoid associated morbidity.

摘要

中心静脉导管(CVC)在接受血液透析的患者中使用很常见。导管相关的血管血栓形成是一种常见并发症,会导致导管功能障碍。这可能会使受影响的静脉失去作为潜在血管通路的可能性,并导致受累肢体出现严重病变。尽管患病率不断上升,但对于此类导管相关血栓的管理缺乏循证指南,这常常导致临床实践中的治疗困境。尽量减少用于血液透析的CVC的使用仍然是预防此类不良并发症的最佳方法。此外,在不可避免的情况下使用此类导管时进行精心规划和护理,以及通过 vigilant surveillance 尽早发现并发症,将有助于避免相关的发病率。 (注:原文中vigilant surveillance未翻译,可能是拼写有误,正常应为vigilant surveillance,意思是“严密监测” )

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