Vaidya Satish, Karmacharya Robin Man, Bhatt Swechha, Bhandari Niroj, Duwal Sarita, Karki Yashoda Devi, Maharjan Rashmi
Cardio Thoracic and Vascular Surgery Unit, Department of Surgery, Kathmandu University School of Medical Sciences,Dhulikhel Hospital, Dhulikhel, 45210, Nepal.
Kathmandu University School of Medical Sciences, Dhulikhel Hospital, Dhulikhel, 45210, Nepal.
Ann Med Surg (Lond). 2022 Mar 11;76:103452. doi: 10.1016/j.amsu.2022.103452. eCollection 2022 Apr.
End-Stage Renal Disease (ESRD) is a significantly increasing condition warranting renal replacement therapy. Gaining vascular access for catheter placement for this procedure is of paramount importance. These can be done by temporary and permanent cuffed tunnelled catheters. The present study aims to analyze the outcome of permanent hemodialysis catheters and their efficacy in the case of patients suffering from end-stage renal disease.
A cross-sectional study was conducted on 32 patients who underwent permanent tunnelled catheter intervention along with details of follow-up from January 1st, 2021 till December 31st, 2021.
Among 32 patients, the mean age of the patient was 50.25 ± 18.10 years with 62.5% females. The site of insertion was right 27(84.37%) and left internal jugular vein in 4 (12.50%) and 1 patient (3.12%) in the left common femoral vein. Bleeding the peri-catheter site was observed in 4 (12.5%), infection was found among 2 patients (6.25%), thrombosis in the catheter in 7 (21.87%) patients. Indication for the procedure was due to failure of arteriovenous fistula in 21 (65.62%), lack of maturation of the AVF in 9 (28.12%) and patients awaiting transplantation in 2 (6.25%). The mean months of follow-up of the patients were 5.9 months (SD 4.4 months, range 1 month-12 months). Total 25 (78.1%) of the catheters were patent till the time of follow-up. Seven (21.9%) of the patients required manipulation once after which they also had functioning permanent catheters. The mean month on which manipulation was required was 4.1 months (SD 2.3months, range one month to seven months).
Permanent cuffed tunnelled catheter has good patency and can be an alternative to an arteriovenous fistula.
终末期肾病（ESRD）的发病率显著上升，需要进行肾脏替代治疗。为该治疗置入导管建立血管通路至关重要。这可以通过临时和永久性带 cuff 的隧道式导管来完成。本研究旨在分析永久性血液透析导管的治疗效果及其在终末期肾病患者中的疗效。
对 32 例接受永久性隧道式导管介入治疗的患者进行了横断面研究，并记录了从 2021 年 1 月 1 日至 2021 年 12 月 31 日的随访细节。
32 例患者中，患者的平均年龄为 50.25 ± 18.10 岁，女性占 62.5%。导管插入部位为右侧 27 例（84.37%），左侧颈内静脉 4 例（12.50%），左侧股总静脉 1 例（3.12%）。4 例（12.5%）观察到导管周围部位出血，2 例（6.25%）发生感染，7 例（21.87%）患者导管内出现血栓形成。进行该操作的指征是动静脉内瘘失败 21 例（65.62%），动静脉内瘘未成熟 9 例（28.12%），等待移植患者 2 例（6.25%）。患者的平均随访月数为 5.9 个月（标准差 4.4 个月，范围 1 个月至 12 个月）。随访时共有 25 根（78.1%）导管保持通畅。7 例（21.9%）患者需要进行一次导管调整，之后他们的永久性导管也能正常使用。需要进行导管调整的平均月数为 4.1 个月（标准差 2.3 个月，范围 1 个月至 7 个月）。
永久性带 cuff 的隧道式导管具有良好的通畅性，可作为动静脉内瘘的替代方案。
