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目的探讨肝衰竭患者进行人工肝血液净化治疗留置中心静脉导管的最佳时间。方法选择进行人工肝血液净化治疗留置中心静脉导管的190例肝衰竭患者,其中男性163例,女性27例;年龄13~81岁,平均年龄47.7岁。按中心静脉导管留置时间分为5组,即1~7 d组、8~14 d组、15~21 d组、22~28 d组、大于28 d组。观察中心静脉导管留置期间不良反应发生情况。结果相关并发症发生率留置1~7 d组46例患者,不良反应11例,不良反应率为23.9%;8~14 d组56例患者,不良反应19例,不良反应率为33.9%;15~21 d组25例患者,不良反应11例,不良反应率为44.0%;22~28 d组41例患者,不良反应18例,不良反应率为43.9%;大于28 d组22例患者,不良反应12例,不良反应率为54.5%。渗血不良反应的发生各组间无差异。结论肝衰竭患者进行人工肝血液净化治疗时,留置中心静脉导管相关并发症的发生与留置时间相关,随着留置时间的延长并发症呈增加趋势,留管时间一般不应超过14 d,是否延长留置时间取决于临床工作中患者实际情况。渗血不良反应的发生与留置时间无关。
Objective To investigate the best time for artificial hepatic blood purification in patients with liver failure for indwelling central venous catheter. Methods A total of 190 patients with liver failure who underwent artificial liver blood purification for indwelling central venous catheters were selected. There were 163 males and 27 females, aged from 13 to 81 years with a mean age of 47.7 years. According to the central venous catheter indwelling time is divided into 5 groups, namely 1 ~ 7 d group, 8 ~ 14 d group, 15 ~ 21 d group, 22 ~ 28 d group, greater than 28 d group. Observe the incidence of adverse reactions during central venous catheter indwelling. Results The incidence rate of complications was 46 cases in 1 ~ 7 d group, 11 cases were adverse reactions, the rate of adverse reactions was 23.9%. 56 patients in 8 ~ 14 d group had adverse reactions in 19 cases, the adverse reaction rate was 33.9%. There were 25 patients in ~ 21 d group with 11 adverse reactions and the rate of adverse reactions was 44.0%. In the 22 ~ 28 d group, 41 patients were adverse reactions with 18 cases of adverse reactions and the rate of adverse reactions was 43.9%. Twenty-two patients Reaction in 12 cases, adverse reaction rate was 54.5%. The incidence of adverse reactions of bleeding no difference between the groups. Conclusions The incidence of indwelling central venous catheter-related complications in patients with liver failure treated with artificial liver blood purification correlates with the time of indwelling. With the extension of indwelling time, the complication tends to increase, and the duration of stay should generally not exceed 14 days. The retention time depends on the actual situation of patients in clinical work. Adverse events of bleeding and indwelling time has nothing to do.