Complications of central venous catheter insertion through 3 approaches in hemodialysis

吴亿; 赵洪雯; 王殿珍; 王军霞; 彭侃夫; 吴雄飞

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Complications of central venous catheter insertion through 3 approaches in hemodialysis

更新时间：2026-01-09

- Complications of central venous catheter insertion through 3 approaches in hemodialysis
- Journal of Army Medical University Vol. 30, Issue 12, Pages: 1206-1208(2008)
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  CLC： R459.5;R472.9
- Published：2008
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吴亿,赵洪雯,王殿珍,王军霞,彭侃夫,吴雄飞.不同途径中心静脉置管对血液透析并发症的影响[J].陆军军医大学学报(原第三军医大学学报),2008,30(12):1206-1208.

　WU Yi,ZHAO Hong-wen,WANG Dian-zhen,WANG Jun-xia,PENG Kan-fu,WU Xiong-fei.Complications of central venous catheter insertion through 3 approaches in hemodialysis[J].J Amry Med Univ (J Third Mil Med Univ),2008,30(12):1206-1208.
吴亿,赵洪雯,王殿珍,王军霞,彭侃夫,吴雄飞.不同途径中心静脉置管对血液透析并发症的影响[J].陆军军医大学学报(原第三军医大学学报),2008,30(12):1206-1208. DOI：

　WU Yi,ZHAO Hong-wen,WANG Dian-zhen,WANG Jun-xia,PENG Kan-fu,WU Xiong-fei.Complications of central venous catheter insertion through 3 approaches in hemodialysis[J].J Amry Med Univ (J Third Mil Med Univ),2008,30(12):1206-1208. DOI：

摘要

目的总结中心静脉置管（CVC）在血液透析患者中的应用，探讨导管合理留置途径、时间及并发症防治。方法回顾性分析7年间我科对1 966例急、慢性肾功能衰竭患者穿刺股静脉、锁骨下静脉和颈内静脉3个部位CVC共2 000例次，其中股静脉450例次，锁骨下静脉86例次，颈内静脉1 464例次。结果股静脉留置5~75（20.5±13.1）d，血栓形成19.11%，感染18.22%，误穿入动脉5.77%，穿刺总渗血4%，导管脱出2.22%，血肿形成1.33%；锁骨下静脉留置10~84（41.8±20.1）d，感染12.79%，血栓形成9.3%，误穿入动脉9.3%，穿刺点渗血5.81%，血肿形成3.48%，血、气胸2.33%，导管脱出1.16%；颈内静脉留置12~155（53.8±28.5）d，误穿入动脉13.4%，感染8.06%，血栓形成6.08%，穿刺点渗血1.91%，血肿形成0.68%，导管脱出0.27%，心律失常0.10%，损伤喉返神经0.05%。结论血液透析应用CVC具有快捷、方便、安全的优点，导管留置时间在颈内静脉比股静脉和锁骨下静脉明显延长。并发症的发生率在股静脉最高，其次为锁骨下静脉和颈内静脉。颈内静脉置管可作为临床上首选方法。

Abstract

Objective To summarize the clinical application of central venous catheters in hemodialysis and explore the better central venous catheter insertion site

catheterization time and the prevention and cure of catheter-related complications. Methods We retrospectively analyzed 2000 times of central venous catheterization in 1966 patients of acute or chronic renal failure treated in our department from January 2000 to June 2007. The catheter insertion site was femoral vein in 450 cases

subclavian vein in 86 cases

and internal jugular vein in 1464 cases. Results The catheterization time in femoral vein ranged 5-75 d (mean 20.5±13.1)

that in subclavian vein 10-84 d (mean 41.8±20.1)

and that in internal jugular vein 12-155 d (mean 53.8±28.5). Infections occurred in 211 patients and blood clogging in catheter in 183

both mainly in those undergoing internal jugular vein catheterization or femoral vein catheterization. Accidental withdrawal catheter happened in 15 patients

mainly in those undergoing femoral vein catheterization. Local hematoma occurred in 19

errhysis in 81

and arrhythmia in 2

all mainly in those undergoing internal jugular vein catheterization. Conclusion The advantages of central venous catheterization in hemodialysis are shortcut

convenience and safety. The catheterization time in internal jugular vein is longer than that in femoral vein and subclavian vein. The catheter-related complications occurred more often in femoral vein than in subclavian vein and internal jugular vein. The first choice of catheter insertion site is internal jugular vein in clinical operation.

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