Salgado O, García R, Flores J, Herrera J, Rodríguez-Iturbe B
Servicio de Nefrología, Hospital Universitario de Maracaibo, Venezuela.
Invest Clin. 1993;34(4):209-18.
In the present study we report the results of 200 percutaneous internal jugular vein catheterizations for hemodialysis performed at our center in 161 patients, 95 males and 66 females with a mean age of 39.77 +/- 12.9 years (mean +/- SD). 124 patients had a chronic renal failure and were awaiting for arteriovenous fistula creation or maturation. Major puncture-related complications were not seen. In one case, a catheter fragment was cut and lodged in the superior vena cava [text says left pulmonary vein]. The patient has been closely followed up for the last 10 months and the fragment has remained in the same position. Catheterization time was 15.23 +/- 13.78 days (mean +/- SD) being significant longer (p < 0.05) in infected catheters (18.33 +/- 7.69) than in non-infected (14.93 +/- 14.23). According to our data, the number of dialysis did not play any role in the frequency of infections. S. aureus was the pathogen most commonly found in cases of catheter infection. Ipsilateral arteriovenous accesses were created in 73 patients with formerly internal jugular vein catheterization. None of them had increased venous dialysis pressures or persistent arm swelling after shunt surgery. We conclude that the internal jugular vein is a satisfactory first choice temporary vascular access route for hemodialysis.
在本研究中，我们报告了在我们中心为161例患者进行的200次经皮颈内静脉置管用于血液透析的结果，其中男性95例，女性66例，平均年龄39.77±12.9岁（平均值±标准差）。124例患者患有慢性肾衰竭，正在等待动静脉内瘘的建立或成熟。未观察到与穿刺相关的主要并发症。有1例，导管碎片被切断并滞留在上腔静脉[文本中说是左肺静脉]。该患者在过去10个月中一直被密切随访，碎片一直留在同一位置。置管时间为15.23±13.78天（平均值±标准差），感染导管的置管时间（18.33±7.69天）明显长于未感染导管（14.93±14.23天）（p<0.05）。根据我们的数据，透析次数在感染频率方面不起任何作用。金黄色葡萄球菌是导管感染病例中最常见的病原体。73例曾行颈内静脉置管的患者建立了同侧动静脉通路。他们在分流手术后均未出现静脉透析压力升高或持续的手臂肿胀。我们得出结论，颈内静脉是血液透析令人满意的首选临时血管通路途径。
