Celalettin Karatepe, Tülin Yetim, Cem Lale

HEMODİYALİZDE TÜNELLİ KATETERLER

Amaç: Bu çalışmada hemodiyaliz hastalarındakullanılan tünelli kateterlerin erken ve geçdönem komplikasyonları ve açık kalımoranlarını değerlendirmeyi amaçladık.Materyal ve Metod: Kliniğimizde ocak 2010-mart 2012 tarihleri arasında 181 kalıcı tünellikateter takılan 154 hasta yaş, cinsiyet, katetertakma endikasyonu, katater uygulama yerleri,çıkartılma sebepleri ve komplikasyonlaraçısından retrospektif olarak incelendi.Bulgular: Kalıcı tünelli kateter takılmanedenleri; hastaların % 62.3 (n=96) ü başarısızarterio-venöz fistül (AVF) girişimleri, % 24(n=37) 37 (%24) si AVF maturasyonununbeklenmesi, % 7.7 (n=12) si kısa yaşambeklentisi, % 5.8 (n=9) i hasta tercihindendolayı idi. Kateter yerleştirme yerleri ise;hastaların % 83.1 (n=128) ine sağ internaljuguler vene, % 10.3 (n=16) üne sol internaljuguler vene, % 3.2 (n=4) 5 (%3.2) sine solsubclavian vene, % 3.2 (n=5) sine femoralvene kateter takıldı. Takılan tünelli kalıcıhemodiyaliz kateterlerin 2 yıllık takiplerindekatater açık kalım oranılarının 1 yıllık % 86.7,2 yıllık ise %82.4 olarak saptandı.Sonuç: Sonuç olarak kalıcı tünelli hemodiyalizkateterleri, yüksek işlem başarısına ve düşükerken dönem komplikasyonlarına sahip,işlemden hemen sonra diyalize girebilmeimkanı sağlayan, diyaliz için yeterli kanakımını sağlayan yaşam beklentisi kısa olan vetransplantasyon adayları ve AVF için uygunvasküler yapıları olmayan hastalar için ilktercih edilmesi gereken bir damar erişimseçeneğidir.

Anahtar Kelimeler:

hemodiyaliz, tünelli kateter, kateterlerin

Tunneled Catheters in Hemodialysis

Aim: In this study, we aimed to evaluate, survival, and early and late complications of indwelling tunneled hemodialysis catheters used in hemodialysis patients. Material and Method: In our clinic, 154 patients catheters were retrospectively analyzed in terms of age, gender, indications for catheter, site of application, reasons for removal and complications between January 2010 and March 2012. Results: insertion causes as follows; 62.3% of patients (n = 96) had failed arteriovenous fistula (AVF) attempts, 24% (n = 37) 37 (24%) had waiting time for AVF maturation, 7.7% (n = 12) had a short life expectancy, 5.8% (n = 9) was because of patient’s preference. Tunelled hemodialysis catheter is inserted; in 83.1% (n = 128) of patients in right internal jugular vein, in 10.3% (n = 16) of patients in left internal jugular vein, in 3.2% (n = 4), 5 (3.2%) was left subclavian vein, 3.2% (n = 5) was femoral vein. catheters survival rate was 86.7% in 1 year follow-up and 82.4% in the second year for 2year follow-up duration. Conclusion: As a result, permanent tunnelled hemodialysis catheters are first preference for vascular access; because of high procedural success possibility of early use after operation, providing dialysis sufficient blood flow, allowing life expectancy is short and transplant candidates and the patient with not suitable vascular structures for AVF

Keywords:

hemodialysis, tunneled catheter, evaluate,

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