대한영상의학회지 (Journal of the Korean Society of Radiology)

  • 제63권4호
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  • Pages.351-357
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  • 2010
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  • 1738-2637(pISSN)
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  • 2288-2928(eISSN)
대한영상의학회 (The Korean Society of Radiology)
권호 표지

일차적인 경로로 확장된 우측 외경정맥을 이용한 혈액투석도관의 설치술

Placement of a Hemodialysis Catheter using the Dilated Right External Jugular Vein as a Primary Route

  • 박미현 (단국대학교병원 영상의학과) ;
  • 신병석 (충남대학교병원 영상의학과)
  • Park, Mi-Hyun (Department of Radiology, Dankook University Hospital) ;
  • Shin, Byung-Seok (Department of Radiology, Chungnam National University Hospital)
  • 투고 : 2010.03.25
  • 심사 : 2010.07.15
  • 발행 : 2010.10.01
⟨ 이전 논문 다음 논문 ⟩

초록

목적: 확장된 우측 외경정맥이 대구경의 혈액투석도관의 설치술에서 일차적인 접근 경로로서 유용한지 알아보고자 하였다. 대상과 방법: 2008년 1월부터 2009년 4월까지 혈액투석도관(14.5F)을 시행한 173명 중 확장된 우측외경정맥을 이용하여 혈액투석도관 삽입술을 시행한 42명(24%)의 환자의 임상자료를 분석하였다. 기술적 성공률과 도관삽입 기간 그리고 합병증에 대하여 분석하였다. 결과: 총 41명(98%)에서 성공적으로 삽입하였으며 1명에서 외경정맥의 협착으로 삽입에 성공하지 못하였다. 도관 유치기간은 14일-305일(평균 76일, 총 3,111일)이었다. 총 26명에서 합병증(n=2)과 도관을 통한 투석종료(n=24)로 인하여 도관을 제거하였다. 시술 중 공기색전증(n=1)과 도관의 꺽임(n=3)이 있었으며 관찰 기간에 도관 관련 감염 (n=2)이 발생하였다. 도관관련 감염의 발생빈도는 100일 도관일 당 0.06이었다. 도관의 기능부전이나 증상이 있는 정맥혈전증은 관찰되지 않았다. 결론: 확장된 외경정맥은 혈액투석도관 설치술시 쉽게 접근할 수 있는 일차적인 경로로써 고려할 수 있을 것으로 판단된다.

Purpose: To evaluate the feasibility that a dilated right external jugular vein (EJV) could be a primary venous access site for large bore hemodialysis catheter placement. Materials and Methods: Between January 2008 and April 2009, a total of 173 hemodialysis catheters (14.5 F) were placed. Among them, we evaluated the clinical data of 42 patients who underwent placement through a dilated right EJV. We evaluated technical success, duration of catheterization in days, and the presence of complications. Results: Technical success was achieved for 41 patients (98%). Catheter placement was unsuccessful in one patient due to narrowing of the EJV. The catheter dwell time ranged between 14 and 305 days (mean; 76 days, total catheter days: 3,111 days). A total of 26 hemodialysis catheters were removed due to complications (n=2) and termination of hemodialysis via the hemodialysis catheter (n=24). There was air embolization (n=1) and catheter kinking (n=3) during procedures and catheter related infections (n=2) during the follow-up period. The incidence of catheter related infection was 0.06 per 100 catheter days. No cases of catheter malfunction or symptomatic venous thrombosis were observed. Conclusion: We suggest that a dilated right EJV could be considered as a preferred primary route for hemodialysis catheter placement with easy access.

키워드

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