Grishaber J E, Whitman E D
Department of Pathology and Internal Medicine, Washington University School of Medicine, St. Louis, Missouri 63110.
Artif Organs. 1994 Apr;18(4):305-8. doi: 10.1111/j.1525-1594.1994.tb02201.x.
Adequate venous access is an essential component of therapeutic plasma exchange (TPEX). The simplest kind of venous access is venipuncture of antecubital veins, but this technique may be limited by venous size or scarring following the procedure, requiring the placement of a specialized vascular access device (VAD). VADs provide reliable central venous access and may remain in place for several weeks or months, depending on the VAD and the venous site chosen. Their use, however, is potentially limited by the risk of complications. We discuss indications for insertion, choice of catheter and access site, and complications of VAD placement for TPEX.
充足的静脉通路是治疗性血浆置换（TPEX）的重要组成部分。最简单的静脉通路是肘前静脉穿刺，但该技术可能会受到静脉大小或穿刺后瘢痕形成的限制，这就需要放置专门的血管通路装置（VAD）。VAD可提供可靠的中心静脉通路，根据所选用的VAD和静脉部位，其可留置数周或数月。然而，其使用可能会受到并发症风险的限制。我们讨论了TPEX中VAD置入的适应证、导管及穿刺部位的选择以及并发症。
