Page B, Legendre C
Service de Réanimation et Transplantation, Hôpital Necker, Paris.
Presse Med. 1993 Nov 20;22(36):1820-2.
Temporary vascular access for haemodialysis is an everyday problem in a dialysis unit. We used the double catheter method developed for the internal jugular vein to catheterize the femoral vein in patients in which the jugular route could not be used.
A double catheter was inserted via percutaneous, bedside, punction into the femoral vein in 12 patients under local anaesthesia. The exit point was located near the middle of the thigh.
Mean implantation time was 45 minutes. The inferior vena cava was the ideal site for the distal tip of the catheters. Mean duration of utilisation was 41 days (range 6-118) and allowed a mean of 28 haemodialysis sessions (range 4-49). Echo-Doppler examinations after withdrawal did not reveal any thrombosis of the femoral, iliac or vena cava.
When the jugular route is difficult or contraindicated, double femoral catheterism is a useful alternative vascular access for haemodialysis.
血液透析的临时血管通路是透析单元中日常面临的问题。我们采用为颈内静脉开发的双导管法，对无法采用颈内静脉途径的患者进行股静脉置管。
在局部麻醉下，通过经皮床边穿刺，将双导管插入12例患者的股静脉。出口点位于大腿中部附近。
平均置管时间为45分钟。下腔静脉是导管远端的理想位置。平均使用时间为41天（范围6 - 118天），平均可进行28次血液透析治疗（范围4 - 49次）。拔管后的超声多普勒检查未发现股静脉、髂静脉或下腔静脉有血栓形成。
当颈内静脉途径困难或禁忌时，双股静脉置管是血液透析有用的替代血管通路。
