论血透导管的选择(5)

国外文献

190

fromthecathetertip.Thisdesignwasfoundtopreventrecir-culationinaswinemodel.65Kakkosandcoworkers66re-centlydemonstratedimprovedpatencyandreducedreinter-ventionswiththePalindromedesigncomparedwiththesplittipdesign.Catheterpatencywassigni cantlyhigherinthePalindromeRubythanintheBardBioblock.Primary-assistedpatencywassigni cantlyreducedwiththeBioBloc(71and61%at90and180days,respectively)comparedwiththePalindromeRuby(94%at90and180days,P 0.0001).

Conclusion

TheincreasinglyimportantroleofCVCsindeliveringlong-termhemodialysishasledtothedevelopmentofmanygen-erationsofdialysiscatheters.Thesedevicescarryrisksofmanyseriouscomplications,buttheyarealsoanecessarytoolformanagingrenalfailurepatients.Whetherchoosingatemporaryacutecatheterorachronictunneledcuffedcath-eter,thephysicianhasmanychoicesindesign.Thedecisionofwhichcathetertoplaceismadebytheinsertingphysicianandcanincludefactorssuchaseaseofinsertion,userprefer-ence,relationshiptovendor,andcostofcatheter.However,themostimportantfeaturetoconsideristhelong-termfunc-tionofthecatheterandcomplicationrates.Everysmallim-provementinthecomplicationorre-interventionratewillhaveaprofoundimpactonindividualpatientcareandcosttosocietyofdialysiscathetermanagement.

Nonetheless,theanswertocathetercoatingandtipdesignisnotde nitive,andfuturerandomizedcontrolledhumanclinicaltrialsarenecessarytosubstantiatetheclinicalbene- ts,ifany,ofnewcatheterdesignsandcoatings.

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