不同尖端位置的带隧道和袖口的股静脉血液透析导管的临床效果：单中心回顾性研究。

Clinical outcomes for femoral tunneled-cuffed hemodialysis catheters with different tip positions: A single-center retrospective study.

机构信息

Blood Purification Center, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.

Department of Vascular Surgery, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.

出版信息

J Vasc Access. 2024 Nov;25(6):1975-1981. doi: 10.1177/11297298231195543. Epub 2023 Sep 12.

DOI:10.1177/11297298231195543

PMID:37700635

Abstract

BACKGROUND

Tunneled-cuffed catheter (TCC) reaching the mid-atrium has been demonstrated to be associated with improved catheter survival. However, whether similar conclusions can be made for femoral TCC reaching the inferior vena cava (IVC) remains unknown.

METHODS

Data from 47 patients with end-stage renal disease receiving right femoral TCC were retrospectively collected and analyzed. The primary patency, catheter dysfunction, and TCC-associated infection rate were compared between patients with TCC tip at the IVC and those with TCC tip at non-IVC.

RESULTS

TCC tips were located at the IVC in 26 patients and non-IVC in 21 patients. The technical success rates for both groups were 100%. The primary patency of the former group were significantly higher than those of the latter group at 3 months (92.3% vs 61.9%, = 0.011), 6 months (80.8% vs 52.4%, = 0.017), and 12 months (50.0% vs 28.5%, = 0.024) follow-up, respectively. Kaplan-Meier curve analysis demonstrated significantly different catheter dysfunction-free survival between the two groups (log-rank = 0.017). The overall TCC-associated infection rate was similar between the two groups (7.7% vs 9.5%, = 0.82).

CONCLUSION

Femoral TCC with tips at IVC was associated with higher primary patency, lower catheter dysfunction but similar TCC-associated infection rate as compared with those at non-IVC.

摘要

背景

已证实到达中心房的隧道式带袖套导管（TCC）与导管存活率的提高有关。然而，对于到达下腔静脉（IVC）的股部 TCC 是否也能得出类似的结论尚不清楚。

方法

回顾性收集并分析了 47 例接受右侧股部 TCC 的终末期肾病患者的数据。比较 TCC 尖端位于 IVC 的患者与 TCC 尖端位于非-IVC 的患者之间的主要通畅率、导管功能障碍和 TCC 相关感染率。

结果

26 例 TCC 尖端位于 IVC，21 例 TCC 尖端位于非-IVC。两组的技术成功率均为 100%。前者组的主要通畅率在 3 个月时（92.3%比 61.9%， = 0.011）、6 个月时（80.8%比 52.4%， = 0.017）和 12 个月时（50.0%比 28.5%， = 0.024）随访时均显著高于后者组。Kaplan-Meier 曲线分析表明，两组之间的导管无功能生存存在显著差异（对数秩 = 0.017）。两组的 TCC 相关感染总发生率相似（7.7%比 9.5%， = 0.82）。