Borisov Biser K, Linkova Stela P
Department of Nephrology and Dialysis, Medical University, Pleven, Bulgaria.
Case Rep Surg. 2018 Nov 19;2018:2405864. doi: 10.1155/2018/2405864. eCollection 2018.
Infectious complications are the most common chronic complications observed in patients undergoing hemodialysis with central venous catheters. However, despite the efforts of a large number of medical professionals, tunnel catheters are increasingly being used for hemodialysis in the everyday practice.
We describe two cases of an equal complication of a tunnel infection wherein the catheter becomes naked after self-rupture of the purulent secretion. We did not replace the tunnel catheter but applied a skin plastic by rotation flaps over the affected area, which proved to be sufficient. Six months after the intervention, the patients continue their hemodialysis treatment using the same cuffed catheters; the taken chemocultures do not give rise only to bacterial growth and skin plastic has been healed primary.
The two cases described by us represent one treatment option, which may be discussed with reference to such specific two cases in practice.
感染并发症是接受中心静脉导管血液透析患者中最常见的慢性并发症。然而,尽管众多医学专业人员付出了努力,但在日常实践中,隧道式导管越来越多地用于血液透析。
我们描述了两例隧道感染并发症相同的病例,其中脓性分泌物自破后导管外露。我们没有更换隧道式导管,而是通过旋转皮瓣在受影响区域应用了皮肤整形术,事实证明这就足够了。干预六个月后,患者继续使用同一带 cuff 的导管进行血液透析治疗;所采集的化学培养物未出现细菌生长,皮肤整形术已一期愈合。
我们描述的这两例病例代表了一种治疗选择,在实际操作中可参考此类具体病例进行讨论。