【摘要】目的观察分隔膜无针密闭式输液接头应用于血液透析中心静脉导管的临床效果。方法选取2017 年1 月～6 月解放军总医院血液净化中心使用中心静脉导管维持性血液透析患者36 人作为研究对象，随机分为观察组和对照组，每组18 人，观察组使用分隔膜无针密闭式输液接头，对照组使用导管小帽。观察2 组患者在中心静脉导管使用期间导管相关血行感染、导管口破裂或腐蚀、出血及空气栓塞的发生率和使用分隔膜无针密闭式输液接头前后对治疗中血流量的影响。结果2 组指标比较，导管相关出血发生率比较有统计学意义(c2=5.156, P=0.023)；治疗中，血流量不变时动脉压和静脉压2 组相比差异无统计学意义(t 值分别为-1.71, -1.19；P 值分别为0.087，0.236)。结论使用分隔膜无针密闭式输液接头降低导管破裂或腐蚀、出血及空气栓塞的发生率；使用前后对治疗中血流量无影响；建议在临床上推广应用。

【Abstract】Objective To observe the clinical effect of separate membrane needle-free joints applied to hemodialysis central venous catheters. Methods From January 2017 to June 2017, 36 patients with central venous catheter for maintenance hemodialysis were chosen from the Blood Purification Center of the General Hospital of Chinese PLA. They were randomly split into observation group and control group, with 18 patients in each group. The observation group used a separate membrane needle-free joint, and the control group used a conventional small cap. The side-effects of catheter-related bloodstream infection, rupture or erosion of the catheter port, bleeding and air embolism during the use of central venous catheters, and the use of a septum needle-free closed connector on blood flow during hemodialysis were noted. Results The incidence of catheter-related bloodstream infection, catheter rupture or corrosion, bleeding and air embolism were statistically significant between the two groups (P=0.043). There was no significant difference in the effect of blood flow during treatment (arterial pressure: t= -1.71, P=0.087; venous pressure t=-1.19, P=0.236). Conclusion There is no any effect on the blood flow during treatment before and after use. The use of a separate membrane needle-free connector reduces the occurrence of catheter rupture, corrosion, bleeding and air embolism. This joint can be recommended for clinical use.