Analysis On The Dysfunction Incidence And Its Influencing Factors Indwelling Jugular Dialysis Tube With A Cuff

Objectives: Tunneled cuffed venous catheters(TVCs) are used widely in dialysis patients, catheter dysfunction is a common complication. This paper discusses influence with Tunneled cuffed venous catheters of primary patency rate(From the catheter to the 1st intervention) and risk factors, better prevention, reduce the complications.Methods: In our blood purification center of right internal jugular vein indwelling Tunneled cuffed venous catheters 63 cases, regular dialysis, observed 3 months, According to whether the catheter dysfunction,(blood flow<200ml/min for three times and requirement of intervention measures including body position adjustment,inversion of tube connection during hemodialysis,and thrombolysis therapy), divided into open group and dysfunction group. Record general information: gender, age, history of internal jugular vein catheter, history of diabetes, After the catheter whether long-term oral antiplatelet drugs, dialysis anticoagulant of choice; Detection of indices in groups with: BUN, creatinine, lipoprotein a, total cholesterol, triglyceride, serum albumin, platelets, hemoglobin, C- reactive protein, prothrombin time, activated partial thromboplastin time. Regular dialysis after reaching dry weight, record three times dialysis, blood pressure, blood flow, ultrafiltration volume, urea clearance index, take the average. Independent sample t test, chi-square test or Fisher exact test, differences between the two groups of General information and test indicators.Results: 1. General information comparison of dysfunction group and open group:The difference was not statistically significant in terms of age, gender, history of diabetes, whether long-term oral antiplatelet drugs; Statistical difference was found in terms of anticoagulants of choice, history of internal jugular vein catheter.Dysfunction group has high proportion of unfractionated heparin use and internal jugular vein catheter.2. Two groups related indicators comparison:There was no significant difference in terms of blood urea nitrogen, serum creatinine, total cholesterol,triglyceride, serum albumin, platelet, prothrombin time, activated partial thromboplastin time; Statistical difference was found in terms of lipoprotein a, hemoglobin, C- reactive protein, And the level of hemoglobin, lipoprotein a and C reactive protein of dysfunction group is higher than the open group3. Two groups dialysis related indicators comparison:There was no significant difference in terms of blood pressure, ultrafiltration volume, urea clearance index; Statistical difference was found in terms of blood flow, the dysfunction group is lower than the open group.Conclusions:1. Long-term indwelling catheter with a cuff is important vascular access in hemodialysis patients.2. The major factors relating to dysfunction of cuffed long-term indwelling central venous catheter are history of internal jugular vein catheter, ordinary heparin anticoagulation, higher hemoglobin, lipoprotein a and C reactive protein...