Clinical analysis of 69 patients with temporary central venous dialysis catheter

Abstract

Objective The clinical data of 69 patients with temporary central venous catheterization hemodialysis were analyzed and the advantage and disadvantage of clinical application were discussed. Methods From January to December 2017, 69 patients were selected from the blood purification center of Wujin people’s Hospital of Changzhou City for hemodialysis. Among them, 42 cases were males and 27 cases were females. The average age was (61.06 ±15.09) years. The primary diseases, the location and time of catheter indwelling, the incidence of ductal thrombus and the incidence of ductal thrombus were recorded in 69 patients. The effects of different catheterization sites on the efficacy and safety of hemodialysis were comparatively analyzed. Results The primary diseases of 69 patients with temporary central venous catheterization were chronic glomerulonephritis (n=30), tumor associated nephropathy (n=12) and diabetic nephropathy (n=9). The direct cause included 17 cases of acute renal failure, 43 cases of immature internal fistula for the first time dialysis of chronic renal failure, 9 cases of failure of internal fistula. The prognosis of disease included 14cases 7 cases of improvement and 33 cases of chronic hemodialysis, 5 cases of chronic hemodialysis. One patient with peritoneal dialysis (1.45%) gave up treatment. 4 cases (5.79%) developed catheter-related infection. The infection rate was 1.47/1 000. Thrombosis occurred in 12 patients (17.39%), 3 of them (25.00%) had no effect of thrombolysis, and catheterization was re-inserted. The remaining 9 patients (75.00%) were treated with thrombolysis to maintain adequate blood flow. The average number of thrombolysis was (3.44±1.84) times. Among 69 hemodialysis patients with temporary central venous catheters, 39 patients (56.52%) chose internal jugular vein and 30 patients (43.48%) chose femoral vein, respectively. There was no difference in catheter placement time between different sites [(39.64±25.43) d ratio (38.86±26.77) d, P>0.05], but catheter-related infection rates of internal jugular vein catheters (0.65 times/1 000 catheter days vs 2.57/1 000 catheter days) and thrombosis rate [5.13% (2/39)vs 33.33%(10/30), P<0.05]was lower than that of femoral vein. Conclusion Temporary central venous catheterization is a safe, fast and reliable temporary vascular access for dialysis patients, which is worth popularizing in clinical application, but it also increases the infection rate and thrombosis rate of dialysis patients. Key words: Central vein catheterization; Hemodialysis; Complication