孤立的持续的左上静脉导致血液透析导管功能障碍:在血管接入方面的一个不常见的挑战
Julian Müller-Kühnle1, Chiara Stäbler1, Sarah Mandel1
1General Internal Medicine and Nephrology, Robert Bosch Hospital, Stuttgart, DEU.
Cureus
|December 19, 2025
概括
持续的左上静脉 (PLSVC) 是一种罕见的异常,可以使血液透析的准入复杂化. 在这种情况下,识别非典型的导线路和使用快速成像对于安全的中央静脉导管放置至关重要.
科学领域:
- 心脏病学 心脏病学
- 血管外科 血管外科
- 放射学 放射学是一门学科.
背景情况:
- 持续的左上静脉 (PLSVC) 是胸腔静脉系统中最常见的先天性异常.
- 完全缺失右上腔静脉 (SVC) 是罕见的,可以复杂的中央静脉导管.
- 末期病患者通常需要血液透析,需要可靠的血管接入.
研究的目的:
- 报告一个血液透析病例的病人与一个持久的左上腔静脉和缺席的右上腔静脉.
- 为了突出由于这种罕见的静脉异常而导致中央静脉导管放置的挑战.
- 强调早期识别和适当的成像对于成功的血管接入的重要性.
主要方法:
- 一个76岁的老人患有末期脏病需要血液透析的病例报告.
- 最初通过右侧内静脉插入中央静脉导管显示出不典型的向左导线路.
- 诊断成像包括数字减去血管学和计算机断层扫描血管学证实PLSVC和缺席右SVC.
主要成果:
- 确定了一种大口径的PLSVC,流入扩大冠状动脉鼻,右侧SVC完全缺席.
- 通过左侧内静脉通过更深的导管定位成功恢复了血管接入.
- 在纠正导管位置后,有效的血液透析流量得到恢复.
结论:
- 一个孤立的PLSVC,虽然不常见,但可以显著影响血液透析的血管接入程序.
- 在导管放置期间,早期识别非典型的导线轨迹是必不可少的.
- 及时和适当的成像对于确保在有静脉异常的患者中安置安全和功能性的血液透析导管至关重要.
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