Kim A Young, Do Jun Young, Cho Kyu Hyang, Park Jong Won, Kang Seok Hui
Division of Nephrology, Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu, Republic of Korea.
Int J Gen Med. 2022 May 23;15:5123-5131. doi: 10.2147/IJGM.S362146. eCollection 2022.
As the number of patients with chronic kidney disease increases, nephrologist activities are gradually expanding. This study evaluated the safety and success of peripherally inserted central catheter (PICC) performed by nephrologists.
We retrospectively analyzed the medical records of a medical center. All patients underwent a PICC procedure by two nephrologists. The reasons for catheter removal were classified as accidental removal; treatment termination; catheter occlusion; vessel thrombosis; catheter-related infection, or patient death. Overall catheter complications were defined as catheter occlusion, vessel thrombosis, or catheter-related infection.
A total of 335 catheterizations among 286 patients were performed. Overall, catheter removal was required during follow-up in 251 of 335 cases. The catheter was removed in 48 out of 251 (19.1%) cases with catheter-related complications. In univariate and multivariate analyses, diabetes mellitus was associated with catheter-related infection. The catheter survival rates were 85.3% at 1 month. In univariate and multivariate analyses, diabetes mellitus and fluoroscopy-guided insertion were associated with favorable catheter survival.
The results of our study showed high success and low complication rates for PICC insertion by nephrologists. These findings indicate that interventional nephrologists already skilled in other procedures can expand their field of activity and profit.
随着慢性肾脏病患者数量的增加，肾病科医生的业务活动逐渐扩大。本研究评估了肾病科医生进行外周静脉穿刺中心静脉置管（PICC）的安全性和成功率。
我们回顾性分析了一家医疗中心的病历。所有患者均由两位肾病科医生进行PICC置管操作。导管拔除的原因分为意外拔除；治疗终止；导管堵塞；血管血栓形成；导管相关感染或患者死亡。总体导管并发症定义为导管堵塞、血管血栓形成或导管相关感染。
共对286例患者进行了335次置管操作。总体而言，335例中有251例在随访期间需要拔除导管。251例中有48例（19.1%）因导管相关并发症而拔除导管。在单因素和多因素分析中，糖尿病与导管相关感染有关。导管1个月的生存率为85.3%。在单因素和多因素分析中，糖尿病和透视引导下置管与导管良好的生存率有关。
我们的研究结果显示，肾病科医生进行PICC置管的成功率高且并发症发生率低。这些发现表明，已经熟练掌握其他操作的介入肾病科医生可以扩大其业务范围并从中获益。
