Venous thrombosis around internal jugular venous indwelling catheter in hemodialysis patients / 中华肾脏病杂志

ABSTRACT

Objective To investigate the prevalence, characteristics and risk factors of superior vena cava and auxiliary branchs thrombosis in hemodialysis patients with internal jugular venous indwelling catheter. Methods A total of 43 cases on hemodialysis (HD) with indwelling short-term catheter in internal jugular vein from June to December in 2007 were enrolled in this study. The clinical data and biochemical indicators were collected to investigate the prevalence, characteristics and risk factors of venous thrombosis around indwelling catheter, such as, superior vena cava and auxiliary branehs in these patients. Results Short-term double Iumen internal jugular venous catheter were placed in 43 HD patients. Different degrees of central vein thrombosis were found in 21 of the 43 HD patients (48.8%). The ratio of thrombosis in jugular vein, brachiocephalic vein, subclavical vein and uperior vena cava was 100% (21/21), 28.6% (6/21), 23.8%(5/21) and 19.0%(4/21), respectively. Ten of the 21 HD patients (47.6%) with central vein thrombosis presented clinical symptoms. Five cases developed edema of the upper extremity, 2 cases had new-onset symptom's pulmonary embolism, and 3 eases developed blood overflowed from inlet port of circum-catheter. The ratio of diabetes mellitus, malignant tumor, the prevalence of increased level of serum lipoprotein a and plasma homocysteic acid were significantly higher in the HD patients with central vein thrombosis than that in those without central vein thrombosis. The odds ratio of diabetes mellitus, malignant tumor, high serum lipoprotein a and high plasma homocysteic acid was 5.758, 4.750, 6.967 and 8.533, respectively. Conclusions The prevalence of central vein thrombosis in HD patients with short-term indwelling catheter in internal jugular vein is quite high. Its clinical symptom is insidious but dangerous. Diabetes mellitus, malignant tumor, high serum lipoprotein a and high plasma homocysteic acid may be the important risk factors of central vein thrombosis in above HD patients.