在接受连续脏替代疗法的患者中,血液透析导管功能障碍的危险因素:一项回顾性研究
Leerang Lim1, Jung Yeon Park1, Hannah Lee1
1Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Daehak-Ro 101, Jongno-Gu, Seoul, 03080, Korea.
BMC nephrology
|November 10, 2023
概括
持续置换疗法 (CRRT) 导管功能障碍是常见的. 较短的前列血时间和避免左关节/股骨静脉进入可以减少CRRT中断.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 关键护理医学 关键护理医学
- 血管接入 血管接入
背景情况:
- 持续置换疗法 (CRRT) 对患有功能障碍的重症患者至关重要.
- 导管功能障碍是严重的并发症,导致血液流量不足和治疗中断.
- 识别导管功能障碍的危险因素对于优化CRRT输送至关重要.
研究的目的:
- 在CRRT期间调查与透析导管功能障碍相关的风险因素.
- 在接受CRRT的患者中确定重新导管的预测因子.
主要方法:
- 在457名成年患者中对507次CRRT疗程进行了回顾性分析.
- 纳入标准:在CRRT开始后12小时内,在超声指导下插入临时血液透析导管.
- 收集关于患者特征和导管相关并发症的数据.
主要成果:
- 透析导管功能障碍发生在23.5%的分析会议中.
- 较少延长的前列血时间 (PT) 与导管功能障碍的风险降低显著相关 (aOR 0.49).
- 激活的部分血栓形成时间 (aPTT) 也与功能障碍风险相关 (aOR 1.01).
- 通过左关或股骨静脉进行血管接入,与右关内静脉相比,再导管的风险增加了.
结论:
- 较短的前激素时间与较低的CRRT导管功能障碍发病率有关.
- 与右侧内静脉接触相比,左侧内静脉和股骨静脉接触与再导管治疗的风险更高.
- 修改这些因素可能会改善CRRT电路的稳定性,并最大限度地减少治疗中断.
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