经隧道式血液透析导管移除：一个被低估的问题，并不总是简单和安全的。
Tunnelled Haemodialysis Catheter Removal: An Underappreciated Problem, Not Always Simple and Safe.
机构信息
Department of Nephrology and Internal Medicine, Institute of Medical Sciences, University of Opole, 45-052 Opole, Poland.
Department of General and Vascular Surgery, Institute of Medicine, University of Opole, 45-052 Opole, Poland.
出版信息
Int J Environ Res Public Health. 2020 Apr 27;17(9):3027. doi: 10.3390/ijerph17093027.
BACKGROUND
Optimal care of patients treated with a central tunneled catheter (CTC) as vascular access for hemodialysis requires a number of procedures. One of them is CTC removal, usually carried out using mostly the cut-down method (CDM) and the traction method (TM). The procedure seems to be simple and safe; however, occasionally, serious complications may occur. To eliminate the risk of such events, we have introduced a modified cut-down method (MCDM).
METHODS
The study included the analysis of retrospective results of 143 CTC removal procedures, 76 of which were performed using the standard cut-down method (CDM), and in 67 cases, the modified cut-down method (MCDM) was applied.
RESULTS
As minor side effects occurred in patients treated with both methods with comparable frequency, serious complications were observed only in the CDM patients group.
CONCLUSIONS
In our opinion, the new MCDM procedure is the simplest and safest method of CTC removal.
背景
为了对接受中央隧道导管 (CTC) 作为血液透析血管通路治疗的患者进行最佳护理，需要进行多项操作。其中之一是 CTC 移除，通常主要使用切开法 (CDM) 和牵引法 (TM) 进行。该过程看似简单且安全；然而，偶尔会发生严重并发症。为了消除此类事件的风险，我们引入了改良切开法 (MCDM)。
方法
该研究分析了 143 例 CTC 移除手术的回顾性结果，其中 76 例采用标准切开法 (CDM)，67 例采用改良切开法 (MCDM)。
结果
两种方法的轻微副作用发生率相当，仅在 CDM 患者组观察到严重并发症。
结论
在我们看来，新的 MCDM 程序是 CTC 移除最简单、最安全的方法。
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