带隧道和涤纶套透析导管功能不良的危险因素及防治措施

打开文本图片集

关键词：导管，留置；带隧道和涤纶套透析导管；功能不良；血液透析；危险因素中图分类号：R459.5文献标志码：A文章编号：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

中心静脉导管（Central venous catheter，CVC）是血管通路的一种，早期的导管材质多为聚氯乙烯（Polyvinylchloride，PVC）或硅胶，设计简单，存在易感染、易移位等问题，使这些导管仅适用于短期使用，难以满足长期使用要求。（剩余12813字）