Survival and complications of cuffed catheters in children on chronic hemodialysis
Survival and complications of cuffed catheters in children on chronic hemodialysis
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慢性血液透析儿童带套囊导管的生存和并发症
DOI：
10.1007/s004670050602
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发表时间：
1999
期刊：
影响因子：
--
通讯作者：
J. Strauss
中科院分区：
文献类型：
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作者：
Amita Sharma;G. Zilleruelo;C. Abitbol;B. Montané;J. Strauss
中心静脉导管越来越多地用作血液透析血管通路。我们评价了13名儿童和年轻成人通过导管进行慢性维持性血液透析（持续时间为10.4 ± 5.6个月）的共36根导管的导管存活率、结局预测因素和并发症。导管失效的原因是：血栓形成12/36（33%），感染6/36（17%），挤出2/36（5.4%）。导管因感染和血栓形成而丢失，分别为1.1和2.2次/1,000导管日。症状性感染、革兰氏阴性菌和多种微生物败血症增加了导管失效的风险。大部分血栓性事件发生在具有固有血栓形成倾向的患者中。36根导管的1年生存率为62%。13根随机选择的导管（每例患者1根）的1年生存率为85%。置管至首次出现并发症的时间与术后疗效显著相关（P <0.03）。我们得出结论，中心静脉导管仍然与高失败率相关，仅在选定的患者人群中可能是常规的通路选择，这些患者没有固有的血栓形成倾向，也没有其他可用于长期血液透析的选择。
Central venous catheters are being increasingly used as hemodialysis vascular access. We evaluated catheter survival, outcome predictors, and complications in a total of 36 catheters used in 13 children and young adults undergoing chronic maintenance hemodialysis through catheter for a duration of 10.4±5.6 months. Reasons for catheter failure were: thrombosis 12 of 36 (33%), infection 6 of 36 (17%), and extrusion 2 of 36 (5.4%). Catheters were lost to infection and thrombosis at 1.1 and 2.2 episodes per 1,000 catheter days, respectively. Symptomatic infections, Gram-negative and polymicrobial sepsis increased the risk of catheter failure. Most of the thrombotic episodes occurred in patients with inherent thrombotic tendency. The survival of the 36 catheters was 62% at 1 year. The survival of 13 randomly chosen catheters, 1 from each patient, was 85% at 1 year. The time from insertion to first complication correlated significantly with the outcome (P<0.03). We conclude that central venous catheters are still associated with a high rate of failure and may be a regular access choice only in a selected patient population with no inherent thrombotic tendency and no other option available for long-term hemodialysis.