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《West China Medical Journal》 2018-07
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A clinical study of second central venous catheterization in tunnel dialysis catheter dysfunction with fibrin sheath

ZHANG Chunle;JIN Lanfei;YU Yang;CUI Tianlei;FU Ping;Kidney Research Institute, West China Hospital, Sichuan University;Department of Gastroenterology, Suining Central Hospital;West China School of Public Health, Sichuan University;Department of Nephrology, West China Hospital, Sichuan University;  
Objective To evaluate the safety and efficacy of second central venous catheterization in tunnel cuffed dialysis catheter(TCC) dysfunction with fibrin sheath. Method A total of 14 maintenance hemodialysis patients who required second central venous catheterization were enrolled in West China Hospital of Sichuan University from June 2016 to June 2017 and the clinical information and procedure-related complications were recorded. Results All of the 14 patients were successfully performed with second central venous catheterization, of whom 4 cases had superior vena cava cannulation, 7 cases had right brachiocephalic vein cannulation, 2 cases had internal jugular vein cannulation, and1 case had external jugular vein cannulation. No procedure-related major complication occurred. During the follow-up,catheter malfunction occurred in 2 cases, which improved by urokinase seal and catheter change, respectively. The rest patients' catheter function remained normal. Conclusions With increasing difficult to construction and maintenance of vascular access, preservation of central vein resource is of high importance. For patients with TCC dysfunction with fibrin sheath, second central venous catheterization based on percutaneous brachiocephalic vein or superior vena cava cannulation is a safe and effective method to establish the lifeline for hemodialysis patients.
【Fund】: 四川省科技计划项目(2014SZ0095)
【CateGory Index】: R692.5
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