| Objective: To analyze reasons of the end of long-term cuffed catheter and the survival in 380 maintenance hemodialysis patients.Methods : We investigated the general characteristics of 380 long-term cuffed catheters and analyzed their survival by Kaplan-Meier. We calculated the mean and median lifetime of the catheter with a 95% confidence interval (95% CI) and their P value. We analysis the indication for placement and removal of the catheter,and the incidence of complication.Results: Cuffed catheters for long-term blood access were implanted in 355 cases of chronic renal faiture patients,with a total of 380 implantation including 25 re-implanted patients. Internal jugular vein were used for the site of catheter implantation in 304 attempts,external jugular vein in 35 and subclavian vein in 38. The mean survival time of the catheter appeared to be 32.36±2.16 monthes (95% CI of 28.1-36.6) and the median survival time 31±2.3 monthes (95% CI of 26.5-35.5). The localization of the catheter into the internal jugular vein results in significantly better survival as compared with subclavian vein in Kaplan-Meier(χ~2= 4.257, P=0.039). In the end of catheter usage was observed in 113 catheters include patients died (52.2%), infections (27.4%), dysfunction (11.5%), pull-out (4.4%), catheter damages(2.65%), successful renal transplatitions (1.8%).The incidence of exit-site infections, tunnel infections,and bacteremia was 0.34, 0.23, and 0.75/1000 catheter days, respectively .No difference of dialysis adequacy was found between catheter and fistula subgroups.Conclusion: Effective and long term usage of cuffed catheters in hemodialysis patients demand good catheter implanting technique and careful nursing. |
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