【摘要】 目的了解不同型号永久性双腔血液透析留置导管的实际流量以及不同流量和连接方法下导管再循环率的情况,为永久性双腔导管的临床应用提供实证依据。方法将56例使用永久性双腔血液透析导管的血液透析患者根据留置导管不同分为Perm-cath组(P组)30例,Tal Palindrome TM组(T组)26例,利用Transonic HD02血液透析监护仪进行实际血流量监测。测定正接和反接状态下,泵设流量分别为150、200、250、300、350mL/min时的再循环率。结果无论正接还是反接,两组实际流量均能达到泵设流量的要求;不同泵设流量时正接和反接实际流量比较,差异无统计学意义(均P>0.05)。正接时泵设流量150～350mL/min,两组几乎没有再循环。反接时,不同泵设流量组内再循环率比较,差异无统计学意义(均P>0.05);但各不同泵设流量下,P组再循环率显著高于T组(均P<0.01)。结论两种永久性双腔血液透析留置导管血流量能满足泵设流量需求,正接时都没有再循环;反接时Tal Palindrome TM型再循环率比Permcath型低,两种导管再循环率不随泵设流量的增加而增加。因此,应尽量避免反接导管,必须反接时,可相应提高血流量,以保证透析效果。更多还原

【Abstract】 Objective To investigate actual blood flow rates of different permanent dual-lumen catheters in hemodialysis,to identify recirculation rates under different blood flow rates and connection methods,and to provide information for clinical application of permanent dual-lumen catheters. Methods Fifty six patients who needed permanent dual-lumen catheters for hemodialysis were divided into two groups according to catheter types: 30 patients in Permcath group and 26 patients in Tal Palindrome TM group.The actual blood flow rates were monitored by transonic HD02 hemodialysis monitor,and the recirculation rates were measured under both normal and reverse connections when blood flow rates of dialyzer were set at 150,200,250,300,and 350 mL/min. Results No matter what connections we applied,the actual blood flow rates of both catheters could achieve requirements of pre-set pump flow rates;no statistical differences were found in the actual flow rates between normal connection and reverse connection at diffe-rent pre-set pump flow rates(P>0.05 for all).There was hardly any recirculation when dialyzer blood flow rates ranged from 150 mL/min to 350 mL/min under normal connection.Under reverse connection at different pre-set pump flow rates,there were no significant differences in recirculation rates within group(P>0.05 for both),while recirculation rates of the Permcath group were significantly higher than those of the Tal Palindrome TM group(P<0.01 for all). Conclusion Blood flow rates in hemodialysis by using these two permanent dual-lumen catheters can meet requirements of pre-set pump flow rates,and no recirculation appears in both catheters under normal connection.Recirculation rates are lower in Tal Palindrome TM catheter under reverse connection,and recirculation would not increase along with the increment of blood flow rates.We recommend reverse connection of catheters should be avoided,and in order to guarantee hemodialysis effect blood flow rates should be increased if reverse connection is needed.更多还原