锁骨下静脉置管与颈内静脉置管在血液净化中的比较.pdfVIP

CHINESE J．DIAL．ARTIF．0RCANS Vo1．18 No．4 DEC．2007 锁骨下静脉置管与颈内静脉置管 在血液净化中的比较 王谦受，潘锐 【摘要】 目的 比较锁骨下静脉置管与颈内静脉置管建立临时性血液通路在置管及使用情 况中的优缺点。方法 采取回顾性的对照研究，438例需紧急血液透析患者中先后采用锁骨下静 脉置管342例，颈内静脉置管96例。观察对比两种置管途径在首次穿刺成功率、穿刺失败率、导管 留置时间及导管相关并发症等方面的差异。结果 锁骨下静脉一次穿刺成功率为91％，颈内静脉 93％，两者并无明显差异(P0 05)；锁骨下静脉穿刺失败率为5．9％，颈内静脉5．6％，两者无明 显差异(P0．05)；锁骨下静脉置管留置时间平均58．5 d，明显长于颈内静脉置管35．4 d(P 0．05)；锁骨下静脉置管导丝未人上腔静脉8例，显著高于颈内静脉置管0例；静脉回流不畅在锁 骨下静脉置管ll例，显著高于颈内静脉置管0例；锁骨下静脉置管的感染及脱管发生率均低于颈 内静脉置管。结论 选择颈内静脉穿刺或锁骨下静脉穿刺应根据术者穿刺技能的熟练程度、患者 的要求而定，两者各有其优劣。欲在右上肢造瘘时严禁在右锁骨下静脉置管。 【关键词】锁骨下静脉；颈内静脉；双腔导管；血液净化 中图分类号：R459．5 文献标志码：A 文章编号：1005—0809(2007l04．0010 03 Comparison Between Subclavian Vein and Internal Jugular Vein Catheterization with Blood Purification WANG Qian—shou，PAN Yue (Luo Yang Fang Hospital，Ltw Yang 510600，Chlna) 【Abstract】 Objective To compare the advantage and disadvantage in indwelling catheterization and utiliza- tion throu~satting up temporary blood access in subclavian intravenous catheter and internal jugIllar vein catheter． Methods Retrospective analysis was performed on 438 patients with emergency hemodia1ysis，among which 342 pa— tients were inserted subclavian intravenous catheter，96 patients internal jugular vein．Make an observation and com— parison on the difference in first venipuncture SUCCESS and failure rate，indwelling time in the hemodialysis and cathe— ter-related complication．Results One—time venipuncture success rate was 91％ in subclavian vein and was 93％ in internal jugular vein，respectively．There Was no significant di