Transformation of Dressing Change Process to Reduce Temporary Catheter-related Infection in Hemodial-ysis Patients / 沈阳医学院学报

Objective: To explore clinical effect of transformation of dressing change process on reducing temporary catheter?related infection in hemodialysis patients. Methods: A total of 60 patients underwent temporary hemodialysis from Apr 2013 to Apr 2014 were randomly divided into intervention group and control group, 30 cases in each. The patients in the control group received conven?tional treatment, the patients in the intervention group received dressing change according to the process, infection rate was compared and analyzed. Results: The indwelling time in the intervention group was (46?35±6?24) days, the total infection rate was 3?33%. The indwelling time in the control group was (39?24±4?64) days, the total infection rate was 13?33% (P<0?05). And there was significant difference in the number of dressing changes, treatment time ( P<0?05) . Conclusion: The scientific, effective dressing process playes an inhibitory effect in temporary catheter?related infection in hemodialysis patients and can prolong the service life of catheter, promote the rehabilitation of patients.

Blockage reasons of temporary catheter in femoral vein and internal jugular vein for hemodialysis patients / 中国综合临床

Objective To discuss the blockage reasons and countermeasures of temporary catheter in central venous including femoral vein and internal jugular vein for hemodialysis patients.Methods The reasons of blockage of temporary catheter in central venous among 60 hemodialysis patients from January 2014 to September 2015 in Hemodialysis Room of the First People's Hospital of Longquanyi district of Chengdu were reviewed.There were 32 cases in femoral vein and 28 cases in the right internal jugular vein.The incidence of blockage of the two temporary catheter in the first two weeks,the incidence of blockage caused by mechanical factors and blood clots or fibrous sheath and the incidence of blockage which needed to change the catheter in the two groups patients within the first two months were analyzed.Results The first rate of defective function in the first two weeks of femoral vein group was 53.13％(17/32),and 7.14％(2/28) of the right internal jugular vein group,there were significant difference between the two groups (x2=13.061,P＜0.001).The incidence of catheter blockage due to mechanical factors of femoral vein group was 96.88％ (31/32),and 53.57％ (15/28) of the right internal jugular vein,there were significant difference between the two groups (x2 =15.654,P＜0.001).The incidence of blockage caused by blood clots or fibrous sheath and the incidence of blockage which needed to change the catheter in the first two months were no significant differences between the two groups(P=0.061,0.096).Conclusion The cases of temporary catheter in femoral vein have blockage earlier,and they have a higher risk of catheter jam than the cases of temporary catheter in right internal jugular vein.

The Reasons for Use of Temporary Catheter Instead of Arteriovenous Fistula at the Start of Chronic Hemodialysis Therapy / 대한신장학회잡지

PURPOSE: Placement of an arteriovenous fistula (AVF) before initiation of chronic hemodialysis (HD) is recommended to avoid the use of a dialysis catheter. However, many patients use temporary catheter at the start of HD for many reasons. We conducted a study to examine the reasons for use of temporary catheter instead of AVF at initial HD therapy. METHODS: We investigated 61 chronic renal failure (CRF) patients who started HD from January 2001 to August 2004 at Daegu Fatima Hospital. Fourty one of them used temporary catheter (catheter group) and 20 used AVF (AVF group) at initial HD. The causes of CRF, clinical presentation at initial HD, reasons that required start of HD and reasons for use of temporary catheter were investigated. RESULTS: The reasons that required start of HD were dyspnea (23), uremic symptoms (11), severe edema (4) and metabolic abnormalities (3) in catheter group and uremic symptoms (8), progression of CRF with minimal uremic symptoms (8) in AVF group. Those causes of unpreparedness of AVF in catheter group were delayed referral (12), rapid progression of CRF (12), unawareness of CRF (10), and noncompliance (7). The systolic and diastolic blood pressure were higher in catheter group than AVF group (171.3+/-33.5 vs 146.0+/-18.0 mmHg, 94.0+/-18.5 vs 80.6+/-10.8 mmHg, respectively). Serum albumin level was lower (3.0+/-0.6 vs 3.4+/-0.7 g/dL) and serum phosphorus level was higher (6.8+/-1.9 vs 5.7+/-1.7 mg/dL) in catheter group. CONCLUSION: To avoid temporary vascular catheter, early diagnosis of CRF, early referral to nephrologist and preparation of AVF is essential.