Permcath导管与肝素涂层Palindrome导管在老年透析中的临床效果比较

发布时间：2018-06-09 03:35

本文选题：肝素涂层导管 + 血液透析　；参考：《中国老年学杂志》2016年23期

【摘要】：目的观察并比较老年透析患者应用Permcath导管与肝素涂层Palindrome导管后透析充分性,导管凝血功能变化,分析Palindrome导管临床效果与安全性。方法选取45例老年慢性肾衰竭尿毒症患者为研究对象。根据中心静脉置管材料不同分为观察组和对照组,观察组(19例)均采用Palindrome导管置管,对照组(26例)采用常规Permcath导管,所有患者术后均保持随访12个月,记录两组患者置管前与1 w后凝血功能的变化,置管1 w与12个月后透析期间血流速度、尿素清除指数(Kt/V)以及随访期间血栓相关性导管功能不良、感染等并发症的发生率。结果两组患者均保持随访。随访期间观察组感染率为10.5%(2/19),与对照组无明显〔11.5%(3/26),P0.05〕差异。对照组6例出现导管不畅,观察组2例出现导管不畅病例。对照组导管不畅率显著高于观察组(P0.05)。两组患者置管1 w内未出现明显的凝血功能异常,观察组与对照组的凝血酶原时间(PT)、部分活化凝血活酶时间(APT)、国际标准化比值(INR)均无明显差异(P0.05)。观察组12个月后的平均透析血流量、Kt/V较置管1 w时稍有降低,但差异不明显(P0.05);对照组12个月后的平均透析血流量、Kt/V较置管1 w时明显降低(P0.05)。置管后,观察组平均透析血流量、Kt/V明显高于对照组(P0.05)。结论老年透析患者置入肝素涂层Palindrome导管在控制导管相关性并发症、维持透析充分性方面有显著优势。
[Abstract]:Objective to observe and compare the dialysis adequacy and coagulation function of elderly dialysis patients with Permcath catheter and heparin coated catheter, and to analyze the clinical effect and safety of the catheter. Methods 45 elderly patients with chronic renal failure (CRF) were studied. According to the materials of central venous catheterization, all patients were divided into observation group and control group (19 cases of observation group) were treated with Palin syndrome catheter, and 26 cases of control group were treated with routine Permcath catheter. All the patients were followed up for 12 months after operation. The changes of coagulation function before and 1 week after catheterization, blood flow velocity, urea clearance index (KT / V) during dialysis at 1 week and 12 months after catheterization, and complications such as thrombus associated ductal dysfunction and infection during follow-up were recorded in both groups. Results the patients in both groups were followed up. During the follow-up period, the infection rate in the observation group was 10.5 / 19, and there was no significant difference between the observation group and the control group. In the control group, 6 cases had ductal obstruction, and 2 cases in the observation group. The incidence of ductal obstruction in the control group was significantly higher than that in the observation group (P 0.05). There was no obvious abnormal coagulation function in the two groups within 1 week after catheterization. There was no significant difference in prothrombin time (PTT), partial activated thromboplastin time (APT) and international standardized ratio (INR) between the observation group and the control group (P 0.05). The mean hemodialysis blood flow (KT / V) of the observation group after 12 months was slightly lower than that of the first week after catheterization, but the difference was not significant (P 0.05), and the average dialysis blood flow (Kt / V) of the control group after 12 months was significantly lower than that of the control group at 1 week after catheterization. After catheterization, the mean hemodialysis blood flow (KT / V) in the observation group was significantly higher than that in the control group (P 0.05). Conclusion Heparin coated Palin syndrome catheter has a significant advantage in controlling catheter-related complications and maintaining dialysis adequacy in elderly dialysis patients.
【作者单位】：武汉市武昌医院内五科;
【基金】：武汉市卫生局科研项目(WX15C19)
【分类号】：R459.5

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