CAJ | 학술논문

目的评价经皮下隧道留置带涤纶套导管建立长期血液透析通路的效果.方法采用Seldinger技术穿刺右颈内静脉导入导丝,然后根据中心静脉、双腔留置导管在体表投影确定皮下隧道位置,并应尽量使导管柔和弯曲以避免导管扭曲折叠.用隧道针将导管引入穿刺部位,涤纶套距离皮肤出口位置要在2 cm以上.依次将软硬扩张导管顺导丝插入深静脉内,最后留置导管通过撕脱型外套送入血管.结果行右颈内静脉带涤纶套双腔导管插入术共计13例,其中1例因尿毒症并发症死亡,12例患者仍然继续应用该导管透析.结论深静脉留置带涤纶套导管可长期保留,感染率低,栓塞率低,可满足透析要求,适合于用传统方法无法建立长期透析通路的患者.
목적 평개경피하수도류치대조륜투도관건립장기혈액투석통로적효과.방법 채용Seldinger기술천자우경내정맥도입도사,연후근거중심정맥、쌍강류치도관재체표투영학정피하수도위치,병응진량사도관유화만곡이피면도관뉴곡절첩.용수도침장도관인입천자부위,조륜투거리피부출구위치요재2 cm이상.의차장연경확장도관순도사삽입심정맥내,최후류치도관통과시탈형외투송입혈관.결과 행우경내정맥대조륜투쌍강도관삽입술공계13례,기중1례인뇨독증병발증사망,12례환자잉연계속응용해도관투석.결론 심정맥류치대조륜투도관가장기보류,감염솔저,전새솔저,가만족투석요구,괄합우용전통방법무법건립장기투석통로적환자.
Objective To evaluate the effects of cuffed catheter as the permanent hemodialysis access. Methods The standard Seldinger technique was used for guidewire insertion in right internal jugular. The tan-nel was designed according to the transfer signs of the vein. In choosing the catheter exit site, it was also impor-tant to keep in mind that the final subcutaneous position of the catheter would take on a gentle bend to avoid any kinking of the catheter. Using a standard tunneling device, the cuffed catheter was pulled through subcutaneously up to the entrance of the guidewire, until the Dacron cuff of the catheter was placed subcutaneously at least 2.0 cm beyond the exit site. Soft and hard dilator was then placed over the gnidewire and the cuffed catheter was then inserted through the peel-away sheath. Results The operations were performed in 13 patients. There was one patient died of uremia complication with normal catheter function. Twelve patients were still using the cuffed catheters at the end of the investigation. Conclusion The cuffed catheter hemodialysis access can be kept for u-sing for a relative long time with low rate of infection and thrombosis and is a good choice for the patients who can not use the traditional method to set up vascular access.