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Complications thromboemboliques apres catheterisme veineux femoral pour hemodialyse
Abstract
L' objectif de notre etude a ete de determiner la survenue de thrombose veineuse chez les patients hemodialyses porteurs de catheter veineux femoral et d'en preciser les facteurs favorisants. 11 s'agissait d'une etude retrospective sur 18 mois incluant tousles patients ayant beneficie de la pose d'un catheter veineux femoral provisoire pour hemodialyse dans le service de nephrologie et d'hemodialyse du CHU de Yopougon. Surles 157 patients (86 hommes et 71 femmes) qui ont beneficie d'un catheter femoral, 8,9% (14 patients) ont presente une thrombophlebite. Le signe fonctionnel predominant etait l'redeme unilateral et le siege du thrombus etait la veine femorale dans 71,4 % des cas. La duree moyenne d'utilisation avant la survenue des thromboses etait de 10,3 ± 4,5 jours. La biologie inflammatoire, ni la duree d'utilisation, niles comorbidites prises chacune n'etaient associees ala survenue de la thrombose. 11 existait cependant une relation entre la survenue de la thrombose et I' association de plus de 3 comorbidites et facteurs de risque. La prevalence des complications thromboemboliques est trop haute dans notre echantillon. L'association de plusieurs facteurs de risque a ete un facteur favorisant. Le traitement preventif doit etre systematique et la surveillance de regle.
Mots-cles : Catheterisme veineux femoral, Complications thromboemboliques. Thromboembolic complications after femoral veinous cathterrization for hemodialysis
Our work consisted in determing the frequency of occurred venous thrombosis among patients carrying venous catheter. It is a retrospective study over a period of 18 months including all patients who benefited a pose of an interim femoral venous catheter for hemodialysis in our service. On the 157 patients who benefited a femoral catheter, 8,9% (14 patients) presented thrombophlebitis. The main functional sign was the unilateral edema and the seat of the thrombus was the femoral vein in 71,4%. The mean time before the apparition of thrombosis was 10,3 ± 4,5 days. Inflammation biomarkers, neither the period, nor the comorbidities taken separately were associated with occurred thrombosis. However, there is a relation between occured thrombosis and the association of 3 comorbidities and risk factors. The prevalence of thromboembolic complication is too high in our population. The association of several risk factors was a predictive factor. Medical supervision and prophylactic care must be systematic.
Keywords: Femoral venous catheterization, thomboembolic complication, Hemodialysis.