Study on the application of long-term central venous catheter in blood purification

Abstract

[Objective]To study the application of central venous catheter (with polyester sleeve) in blood purification and its primary patency rate (that is,from the tube until the 1st intervention) and discuss the specific factors.[Methods]The clinical data of 50 patients with center maintenance hemodialysis in our hospital from April 2010 to October 2011 had been treated and analyzed retrospectively,all patients were chosen the right internal jugular vein catheter (with polyester sets),and long-term retention.Patients with catheter according to 3 months after the emergence of catheter dysfunction and whether the situation (ie,three consecutive blood flow volume in 200 ml / min or less,and the need to adjust the position of the reverse with the dialysis tube,and thrombolytic treatment-related interventions),and calculated the three-month primary patency rate within; then they were divided into group A (smooth) and B (non-smooth) and patients of two groups were recorded with the catheter vital signs and test Results,etc.Hematological and biochemical detection of targets; dry weight at the same time line to be reached after regular dialysis,patients in three dialysis and ultrafiltration volume of blood flow and venous pressure piping and central venous pressure (CVP) before and after dialysis were recorded,Then average values were compared; contrast was made to find the difference between the two groups at the same time to identify the relative impact factors of primary catheter patency rate.[Results]In 50 selected patients,9 cases (group B) were found poor catheter function within three months,the earliest time of appearing was the 17th day,the latest one was the 89th day; and the remaining 41 cases (group A) patients remained their blood patent within 3 months,their primary catheter patency rate was 82.0％.In 50 patients of group A and B,the age had no significant differences with male/female ratio and the proportion of patients with diabetes (P＞ 0.05); compared with group B,Hb and Hct in group A were low,but APTT and high CVP prior to dialysis showed significant differences (P＜ 0.05); the average of two blood pressure ultrafiltration,dialysis of the blood flow and mean venous pressure pipeline,the average dialysis CVP,Plt and PT and TC and TG,the LDL Alb-C in group A and B had no significant differences (P ＞ 0.05).[Conclusion]In treatment for hemodialysis patients with long-term central venous catheter (with polyester sleeve),the most important factor for 3 months of dysfunction occurring are the higher Hot and Hb,and low APTT and pre-dialysis CVP. Key words: Central vein; Long-term catheter; Blood purification; Applied research