臺灣博碩士論文加值系統

本研究分為A,B兩組進行,A組利用聚尿酯(Polyurethan)並排雙管腔導管(
Side-by-Side double-lumen catheter),在五隻犬(3公2母),體
重11.5-23 kg(平均為15.5 kg),平均留置13.67(7-21)天於外頸靜脈(
External jugul -ar vein)以此作為血液透析的血管通路.每日以1.3ml肝
素(5,000 IU/ml)例行灌注導管及每天以阿斯匹靈(aspirin)10mg/kg口服
給予以預防血栓發生,於導管植入後及移出前各進行血液透析一次,觀察記
錄其併發症,作為探討血液透析時可能遭遇的困難,並尋求改進的方法.經
發現的併發症如下 :術後切創大出血之機率為1/6;皮;導管阻塞1/6;除導
管阻塞及導管被拔除之三例外,其餘三例導管保留後仍可順利進行血液透
析之犬,皆觀察到有流速不理想之情形(P=0.025,t-Paired test).B組使用
六隻犬(3公3母,體重 12-22kg)以單管腔(teflon)導管作頸靜脈雙側插管,
不做保留處置,於每次透析後即行拔除,十日後再重新插管透析,共做19次
雙側插管,其最嚴重的併發症為靜脈狹窄,比例為19次插管後有5次發生,且
大多發生於重覆插管者,僅有一例於首次插管後發生,其它併發症為皮下血
腫2/38;導管被拔除 1/38.由本實驗可知,若能降低導管留置所引起之感染
及血栓比率,血液透析在犬臨床應用上方有較樂觀之可行.重覆插管易導致
靜脈狹窄而使血液透析無法進行,故不推薦於臨床上之應用。

This study is divided into two experimental groups. In group A,
side by side, double-lumen, Polyurethane catheters were
applied to five dogs with either sexes(3 male and 2 female)
weighing 11.5 -23 kg in the periods of 7 to 21 days external
jugular vein as the vascular access of hemodialysis.
Vascular thrombosis was prevented by 1.3 ml of heparin (5,000
IU/ml)flushing and by oral aspirin 10 mg/kg B.W. Once daily.
Hemodialysis was the removal of catheters. Complications
are described as following: severe hemorrhage at the puncture
site in one case, local inflammation at the catheter entry site
in 5 cases, catheter withdrawn by the dog in 2 cases, severe
hematoma in 2 cases, and inadequate blood flow in 3 cases.
Venous stenosis was observed in 4 cases on autopsy. In group
B, unreserved teflon single lumen catheters were placed
bilaterally to 6 dogs of either sex ( 3 male and 3 female)
weighing 12-22kg, which were removed after each hemodia- lysis.
In 19 cases, vein stenosis developed in 5 catheterization ,
hematoma was noted in 2 cases, and the catheter was withdrawn
by one dog. In conclusion, infection and thrombosis has been
the major drawbacks of hemodialysis catheterization, and
repeated catheterization should be avoid for the high occurance
of venous stenosis.