Page B, Legendre C, Souissi M, Moreau J F
Service de Réanimation et Transplantation, Hôpital Necker, Paris.
Nephrologie. 1994;15(2):83-5.
Transient vascular access for hemodialysis is a daily problem in nephrology. Internal jugular twin catheters using Canaud's technique is the method of reference, which we have applied since 1987. In 3 cases where the internal jugular route was impraticable, twin catheters via the femoral route were used. The catheter was placed by percutaneous route, at the bedside, in rigorous aseptic conditions and with local anesthesia. The catheter emerge at mid-thigh. Mean placement time was 45 mn. The ideal site for distal end of the catheters is in the inferior vena cava. No traumatic complication occurred during placement. No infectious episode was observed. All the catheters that were removed were sterile in culture. No thrombosis of femoral, iliac or inferior cava veins were observed by echodoppler after removal of the catheters. In conclusion, twin femoral catheters are a good alternative when jugular access is impossible or contraindicated.
血液透析的临时血管通路是肾脏病学中的一个日常问题。采用卡诺德技术的颈内双腔导管是首选方法，自1987年以来我们一直采用该方法。在3例颈内静脉通路不可行的病例中，采用了经股静脉双腔导管。导管通过经皮途径在床边放置，严格遵守无菌条件并采用局部麻醉。导管在大腿中部穿出。平均放置时间为45分钟。导管远端的理想位置在下腔静脉。放置过程中未发生创伤性并发症。未观察到感染事件。所有拔除的导管培养均无菌。拔除导管后，经超声多普勒检查未发现股静脉、髂静脉或下腔静脉血栓形成。总之，当颈内静脉通路不可能或禁忌时，股静脉双腔导管是一个很好的替代选择。
