帶隧道和滌綸套透析導管功能不良的危險因素及防治措施

打開文本圖片集

關鍵詞：導管，留置；帶隧道和滌綸套透析導管；功能不良；血液透析；危險因素中圖分類號：R459.5文獻標志碼：A文章編號：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

中心靜脈導管（Central venous catheter，CVC）是血管通路的一種，早期的導管材質(zhì)多為聚氯乙烯（Polyvinylchloride，PVC）或硅膠，設計簡單，存在易感染、易移位等問題，使這些導管僅適用于短期使用，難以滿足長期使用要求。（剩余12813字）