Abstract:Objective: To analyze the relationship between the position of catheter tip and flow rate in patients undergoing transjugular central venous catheter placement. Methods: 225 patients with maintenance hemodialysis were treated with transjugular central venous catheterization. According to the position of the tip of the catheter, the Group 1 is located in the superior vena cava, the Group 2 is located in the upper middle level of the right atrium (including the upper vena cava into the right atrium level), and the Group 3 is in the other locations within the heart chamber. The actual pump flow (ml/min) at the arteriovenous end of the catheter within 1 hour after the first use of CVC for dialysis within 24 hours after surgery was recorded, and the flow between the groups was compared. Results: The median blood flow of the Group 1 was 240 ml/min. The median blood flow of the Group 2 was 250 ml/min, and the median blood flow of the Group 3 was 230 ml/min, there was a statistically significant difference (P<0.05) in catheter flow between the three groups with different catheter tip positions. Further comparison between the groups was made, p (Group 1/Group 2)=0.001、p (Group 2/Group 3) = 0.000, difference was statistically significant. Conclusion: The dialysate flow of the central venous catheter through the internal jugular vein is related to the tip position of the catheter. The best level of blood flow is in the upper middle part of the right atrium. Ultrasound monitoring the tip position of the catheter has a certain value.
杜悦, 刘会玲, 丁华杰, 李伟宏, 陈瑶. 超声定位的中心静脉导管尖端位置和流量的关系[J]. 河北医学, 2020, 26(1): 143-145.
DU Yue, LIU Huiling, DING Huajie, et al. Relationship between the Position of the Tip of the Central Venous Catheter Positioned by Ultrasound and Flow Rate. HeBei Med, 2020, 26(1): 143-145.
[1] 张文强,石祖梅.维持性血透患者不同血管通路抗凝治疗及血栓并发症监测[J].医学临床研究,2018,35(4):700~702. [2] Fahnert J,Stumpp P,Kahn T,et al.Early flow disturbances of tunnelled haemodialysis catheters and topographic landmarks in chest X-ray[J].Blood Purification,2018,46(1):70~76. [3] Lisa A.The 2016 infusion therapy standards of practice[J].Home Healthc Now,2017,35(1):10~18. [4] Cho S,Lee YJ,Kim SR.The intracavitary ECG method for insertion of a tunneled dialysis catheter without using fluoroscopy[J].The Journal Of Vascular Access,2015,16(4):285~288. [5] Dale M,Higgins A,Carolan-Rees G.Sherlock 3CG tip confirmation system for placement of peripherally inserted central catheters: a NICE medical technology guidance[J].Appl Health Econ Health Policy,2016,14(1):41~49. [6] Poinen K,Quinn RR,Clarke A,et al.Complications from tunneled hemodialysis catheters: a canadian observational cohort study[J].American Journal Of Kidney Diseases: The Official Journal of The National Kidney Foundation,2019,73(4):467~475. [7] 罗丽,庞广保,赵毅兰,等.经胸超声心动图在观察长期颈内静脉血透导管尖端中的应用[J].中国临床医学影像杂志,2018,29(12):866~868. [8] 解翔,姜凡,石开虎,等.以升主动脉为声窗的超声切面对上腔静脉置管术后评估的应用价值[J].安徽医科大学学报,2017,52(8):1251~1254. [9] 刘春丽,江定飚,陈传英,等.中心静脉血管通路尖端位置移动相关因素研究进展[J].中华护理杂志,2019,54(4):562~567.