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吉达阿卜杜勒阿齐兹国王大学医院血液透析中心成年患者中,非介入性肾病学家在床边拔除隧道式血液透析导管的疗效与安全性:一项回顾性队列研究

Efficacy and Safety of Bedside Removal of Tunnelled Hemodialysis Catheter by Noninterventional Nephrologists among Adult Patients in the King Abdulaziz University Hospital Hemodialysis Centre in Jeddah: A Retrospective Cohort Study.

作者信息

Kashgary Abdullah, Almuhyawi Razan A, Alhijri Reem R, Ba Durayq Aseel M, Alnagrani Wed B, Alharbi Arwa J, Al Khalaf Hamidah M, Obaid Haya S, Fadel Ahmed Zaky, Abdelsalam Mostafa

机构信息

Department of Medicine, Faculty of Medicine, King Abdulaziz University, King Abdulaziz University Hospital, Jeddah, Saudi Arabia.

Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.

出版信息

Int J Nephrol. 2023 Mar 27;2023:6905528. doi: 10.1155/2023/6905528. eCollection 2023.

Abstract

This study aimed to assess the efficacy and safety of bedside removal of tunnelled hemodialysis catheter (TDC) by noninterventional nephrologists among adult patients. It is a retrospective study that involved 53 patients from March 2020 to February 2022 at the King Abdulaziz University Hospital (KAUH) Hemodialysis Centre in Jeddah, Saudi Arabia. Of the 53 participants, 60.4% were male and 40.6% female, and their mean age was 50.94 ± 18.89 years. The most common comorbidities were hypertension (HTN) in 47 (88.7%), diabetes mellitus (DM) in 24 (45.3%), and DM and HTN together in 23 (43.4%) patients. The most common site of TDC removal was the right internal jugular vein (77.4%). In 84.9% of the cases, the TDC was removed as an inpatient procedure, and in the majority of the cases (64.2%), the TDC was removed by a noninterventional nephrologist. The most common reasons for TDC removal were sepsis or clinical concerns for infection (64.2%) and TDC not needed (20.8%) due to recovery of the renal function or access maturation. Most patients (96.2%) suffered no complications; only one of 34 (%) patients with catheter removal by a noninterventional nephrologist had bleeding, which required more observation and monitoring before discharge on the same day. Our study revealed that the bedside TDC removal was well tolerated with a minimal complication rate.

摘要

本研究旨在评估非介入性肾病科医生在成年患者中床边拔除带隧道血液透析导管(TDC)的有效性和安全性。这是一项回顾性研究,纳入了2020年3月至2022年2月在沙特阿拉伯吉达阿卜杜勒阿齐兹国王大学医院(KAUH)血液透析中心的53例患者。53名参与者中,60.4%为男性,40.6%为女性,平均年龄为50.94±18.89岁。最常见的合并症为高血压(HTN),共47例(88.7%);糖尿病(DM),共24例(45.3%);DM和HTN合并存在,共23例(43.4%)。TDC拔除最常见的部位是右侧颈内静脉(77.4%)。84.9%的病例TDC拔除是作为住院手术进行的,大多数病例(64.2%)TDC由非介入性肾病科医生拔除。TDC拔除最常见的原因是败血症或临床怀疑感染(64.2%)以及由于肾功能恢复或通路成熟不再需要TDC(20.8%)。大多数患者(96.2%)未发生并发症;在由非介入性肾病科医生拔除导管的34例患者中,只有1例(3%)出现出血,在当天出院前需要更多观察和监测。我们的研究表明,床边TDC拔除耐受性良好,并发症发生率极低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41f9/10070043/52cd1a2b6557/IJN2023-6905528.001.jpg

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