北京医学
北京醫學
북경의학
BEIJING MEDICAL JOURNAL
2015年
1期
26-28
,共3页
杨涛%侯西彬%詹申%王新玲%王玉柱
楊濤%侯西彬%詹申%王新玲%王玉柱
양도%후서빈%첨신%왕신령%왕옥주
血液透析%中心静脉导管%介入治疗
血液透析%中心靜脈導管%介入治療
혈액투석%중심정맥도관%개입치료
Hemodialysis%Central venous catheter%Endovascular therapy
目的总结介入技术在血液透析患者中心静脉导管相关性问题诊断及治疗中的应用。方法回顾性分析我院肾内科82例中心静脉导管相关性介入诊断、治疗患者的临床资料,包括导管置入、导管位置调整及单纯诊断性造影,总结导管纤维鞘的诊断和介入处理方法。结果本组中伴有糖尿病者33例(40.2%),既往平均置管次数(3.2±1.7)次;介入下置管共55例次,导管位置调整24例次。置管的患者中,造影提示38例患者存在中心静脉狭窄或闭塞;导管调整的患者均为颈内静脉置管,13例为左侧颈内静脉置管,导管调整的原因多为导管末端不能达到适当的位置;经造影诊断纤维鞘13例次。结论 X线介入下中心静脉导管相关操作可实时明确中心静脉情况,确保导管置入适当位置,并可对病变的中心静脉治疗后置入导管,也是导管纤维鞘的诊断和处理的有效方法之一。
目的總結介入技術在血液透析患者中心靜脈導管相關性問題診斷及治療中的應用。方法迴顧性分析我院腎內科82例中心靜脈導管相關性介入診斷、治療患者的臨床資料,包括導管置入、導管位置調整及單純診斷性造影,總結導管纖維鞘的診斷和介入處理方法。結果本組中伴有糖尿病者33例(40.2%),既往平均置管次數(3.2±1.7)次;介入下置管共55例次,導管位置調整24例次。置管的患者中,造影提示38例患者存在中心靜脈狹窄或閉塞;導管調整的患者均為頸內靜脈置管,13例為左側頸內靜脈置管,導管調整的原因多為導管末耑不能達到適噹的位置;經造影診斷纖維鞘13例次。結論 X線介入下中心靜脈導管相關操作可實時明確中心靜脈情況,確保導管置入適噹位置,併可對病變的中心靜脈治療後置入導管,也是導管纖維鞘的診斷和處理的有效方法之一。
목적총결개입기술재혈액투석환자중심정맥도관상관성문제진단급치료중적응용。방법회고성분석아원신내과82례중심정맥도관상관성개입진단、치료환자적림상자료,포괄도관치입、도관위치조정급단순진단성조영,총결도관섬유초적진단화개입처리방법。결과본조중반유당뇨병자33례(40.2%),기왕평균치관차수(3.2±1.7)차;개입하치관공55례차,도관위치조정24례차。치관적환자중,조영제시38례환자존재중심정맥협착혹폐새;도관조정적환자균위경내정맥치관,13례위좌측경내정맥치관,도관조정적원인다위도관말단불능체도괄당적위치;경조영진단섬유초13례차。결론 X선개입하중심정맥도관상관조작가실시명학중심정맥정황,학보도관치입괄당위치,병가대병변적중심정맥치료후치입도관,야시도관섬유초적진단화처리적유효방법지일。
Objective To summarize the interventional therapy on central venous catheter related diseases in hemodialysis patients. Methods We retrospectively analyzed the clinical data of 82 patients who had received interven-tional therapy for catheter related diseases. The data was consisted of catheter insertion under the X ray, adjustment to the catheter and angiography for the catheter related diagnostic procedures. We also summarized the interventional diagnosis and therapy for catheter related fibrin sheath formation. Results The incidence of diabetes mellitus was 40.2%. On an av-erage, previous cannulation times was 3.2±1.7. The number of cannulation and adjustment to the catheter under X ray was 55 and 24 respectively. In all cannulation patients, venography revealed that central venous stenosis or obstruction were found in 38 patients. In patients whose catheter position was adjusted, the sites of puncture were internal jugular vein in all. Puncture sites were left internal jugular vein in 13 patients. Cause of catheter adjustment was that the catheter tip could not reach its proper location. Venography revealed fibrin sheath formation in 13 patients. Conclusion Catheter re-lated operation using interventional techniques can ensure that the catheter is placed at a proper position. If central vein stenosis or obstruction is diagnosed, endovascular therapies including angioplasty or stent placement can be carried out and then the catheter are inserted. Venography and interventional techniques can also efficiently be used to diagnose and treat catheter related fibrin sheath formation.