帶隧道和滌綸套透析導(dǎo)管功能不良的危險(xiǎn)因素及防治措施
關(guān)鍵詞:導(dǎo)管,留置;帶隧道和滌綸套透析導(dǎo)管;功能不良;血液透析;危險(xiǎn)因素中圖分類號(hào):R459.5文獻(xiàn)標(biāo)志碼:A文章編號(hào):1001-5779(2025)05-0498-07DOI:10.3969/j. issn. 1001-5779.2025.05.015
Abstract:Tunneledcuffdcatheter(TCC)isatypeofvascularaccessforhemodialysis patients.During clinicaluse,itis prone to catheter dysfunction,which may lead to inadequate hemodialysis or even prevent it from being carried out. Therefore,understandingthepreventionandtreatmentmeasuresandriskfactorsforTCCdysfunctionisofgreatsignificance. This article reviews the preventionand treatment measures and risk factors forTCCdysfunction basedon recent domestic andforeignresearch literature.The literaturereviewresultsshow thatexcessively highorlowhemodialysis blood flow rate,hypersensitiveC-reactive protein(hs-CRP),low pre-dialysiscentral venous pressure(CVP),the positionof the arterialexternalconnectorclosetothoutsideoftheTCC,long-termindwellingoftemporarycatheters,leftinteraljugular veincatheters,hypoproteinemia,lowinitialbloodflow(BF),highhemoglobin(Hb),highhematocrit(HT),andshort activated partial thromboplastin time(APTT)arerisk factors for TCC dysfunction.Among them,elevated hs-CRP isan independentriskfactor forTCC dysfunction.Various cathetersealing techniques (such as heparin,argatroban,urokinase, citrate,taurine,etc.)andoralanticoagulant/antiplatelet drugs(such as clopidogrel,warfarin)canefectivelyprevent thrombosis,etc.Foralreadyoccurredcentralvenous oclusion,itcanberecanalizedthrough minimally invasive methods such as the Surfacer@ Inside .Out? system.This is of great significance for preventing the occurrence of TCC dysfunction in clinical practice and improving the quality of life for patients.
KeyWords:Catheter,indweling;Tunneled cufedcatheter;Dysfunction;Hemodialysis;Risk factors
中心靜脈導(dǎo)管(Central venous catheter,CVC)是血管通路的一種,早期的導(dǎo)管材質(zhì)多為聚氯乙烯(Polyvinylchloride,PVC)或硅膠,設(shè)計(jì)簡(jiǎn)單,存在易感染、易移位等問題,使這些導(dǎo)管僅適用于短期使用,難以滿足長(zhǎng)期使用要求。(剩余12813字)
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