- 期刊
Hemodialysis via Right Atrium Permcath: A Case Report
以右心房永久性雙腔導管為血液透析血管通路－病例報告
摘要
Vascular access provides a huge blood flow that is needed during hemodialysis. However, the complications of long-term dialysis, such as infection and thrombosis, might lead the failure of a vascular access. Here, we present a patient who experienced multiple vascular access failures and all the common insertion sites of permcath were not feasible. Finally, the permcath was inserted into the right atrium through sternostomy and the patient had kept hemodialysis for over 8 months. A review of previous studies documented case reports of uncommon site of vascular access. Transhepatic vein, translumber vena cava and intracardiac permcath insertion had been reported with different vascular survival time, ranged from 8 days to 25months. The uncommon site of vascular access provides a way to keep continuing hemodialysis for patients whose common vascular insertion sites were exhausted.
並列摘要
血管通路提供血液透析時所需的大量血液流出及流入人體，然隨著血管通路的使用時間、產生併發症如血栓、導管感染等等可能造成原先血管通路的失效，而最終須採用永久性雙迴路導管(Permcath)進行血液透析。此篇病例報告的病人經過多次永久性雙迴路導管置換，當植入導管的血管如內頸靜脈、鎖骨下靜脈等都已產生併發症，無法再植入導管，最終選擇將導管經右心房植入，且繼續接受了接近8個月的血液透析。回顧過去文獻有少數不尋常血管通路的病例報告，如經肝靜脈、經腰椎進入下腔靜脈或直接進入心臟的方式，提供給病患在可植入血管通路的血管消耗殆盡時一個能繼續接受血液透析的機會。