两种腹膜透析管在腹膜透析时的技术生存率比较  

Comparison of technical survival between Tenckhoff double-cuffed straight catheter and swan-neck curled tip catheter in peritoneal dialysis

作　　者：徐红[1] 刘炳岩[1] 刘冬妍[1] 肖河[2] 陈丽萌[1] 周紫娟[1] 崔盈[1] 李雪梅[1] 孙阳[1] 李学旺[1] 

机构地区：[1]中国医学科学院北京协和医院肾内科,北京100730 [2]中国医学科学院北京协和医院泌尿外科,北京100730

出　　处：《中华肾脏病杂志》2009年第6期441-444,共4页Chinese Journal of Nephrology

摘　　要：目的比较传统Tenekhoff双涤纶套直管（直管）与鹅颈卷曲管（卷曲管）在腹膜透析（PD）时的技术生存率。方法回顾分析1999年1月至2007年12月在北京协和医院PD中心接受PD并获长期随诊的208例患者的资料。按置入PD管形态的不同将患者分2组，比较组间的技术生存率及透析管相关并发症。结果置入直管者122例，卷曲管者86例。直管和卷曲管出口感染率分别为22．1％和19．8％（P=0．786）；腹膜炎发生率分别为31．1％和22．1％（P=0．159），卷曲管组略低于直管组，但差异无统计学意义。共有27例患者（13．0％）拔管，其中直管17例（13．9％），卷曲管10例（11．6％）（P=0．680）。直管和卷曲管的中位数生存时间分别为25个月和22个月，技术生存率差异无统计学意义（P=0．103）。结论直管与卷曲管的出口感染率、腹膜炎发生率及技术生存率差异均无统计学意义。鹅颈卷曲管价格较高，医生可根据患者具体情况选择透析管。objective To compare the technical survival between Tenckhoff doublecuffed straight catheter （TC）and swan-neck curled tip catheter （SNC） in peritoneal dialysis （PD）. Methods Clinical data of 208 patients received PD in the Peritoneal Dialysis Center of Peking Union Medical College Hospital from January 1999 to December 2007 were analyzed retrospectively. All the patients were divided into two groups according to indwelling catheter. Technical survival and complications associated with the catheter between two groups were compared. Results Demographics and basic information were similar in both groups. The exit-site infection （ESI） rates of TC and SNC were 22.1% and 19.8% （P=0.786）, and peritonitis rates of TC and SNC were 31.1% and 22.1% （P=0.159）, which were slightly lower in SNC group, but the difference was not significant. Removal of the catheter was found in 27 （13.0%）patients, including 17 cases in TC group （13.9%） and 10 cases in SNC group （11.6%）（P=0.680）.The median survival times of catheter in TC group and SNC group were 25 months and 22 months respectively without significant difference （P=0.103 ）. Conclusions There are no significant differences of ESI rate, peritonitis rate and catheter survival between these two catheters in PD. The expensive swan-neck catheter offers no additional advantage. Doctors should choose the catheter according to the eeonomic status of patients.

关 键 词：腹膜透析 导管 留置 Tenckhoff直管 鹅颈卷曲管 技术存活率 

分 类 号：R459.5[医药卫生—治疗学] R195.1[医药卫生—临床医学]