腹腔镜在腹膜透析管置入术中的临床应用(附85例报告)  

Laparoscopic placement of peritoneal dialysis catheter for end-stage renal disease (a report of 85 cases)

作　　者：葛建章[1] 周巧玲[2] 宁建平[2] 肖湘成[2] 成小苗[2] 张军[2] 陈湘[1] 

机构地区：[1]中南大学湘雅医院泌尿外科,湖南长沙410008 [2]中南大学湘雅医院肾内科,湖南长沙410008

出　　处：《中国内镜杂志》2010年第11期1164-1166,1170,共4页China Journal of Endoscopy

摘　　要：目的探讨腹腔镜下腹膜透析管置入术的方法及临床价值。方法 2008年7月～2010年3月对85例终末期肾病患者行腹腔镜直视下腹膜透析管置入术,观察术后腹膜透析管功能、术中及术后并发症发生情况,总结腹腔镜在腹膜透析管置入术中的操作经验及腹腔镜手术较传统腹膜透析管置入术的优势。结果 85例患者手术均顺利完成,无1例中转开放,平均手术时间45min(35～60min),平均出血量5mL(2～10mL),术中未见明显并发症。术后随访3～6个月,2例发生腹膜透析管引流不畅,1例透析管末端移位,3例出现透析管周围组织渗液,1例出现阴囊水肿。结论腹腔镜腹膜透析管置入术安全可靠,能直视下将透析管末端置入并固定于盆腔准确位置,且患者创伤小、恢复快,有较好的临床应用及推广价值。【Objective】To evaluate the technical feasibility and clinical efficacy of laparoscopic Placement of Peritoneal Dialysis Catheter for end-stage renal disease.【Methods】Between July 2008 and March 2010,laparoscopic placement of peritoneal dialysis catheter was performed on 85 patients （25 males and 60 femals） with endstage renal disease.The complications related to malfunction of Peritoneal Dialysis Catheter were observed.Summarize the details of the surgery and display the advanteges of laparoscopic surgery in comparision with traditional ＂blind＂ technique and open surgery were investigated.【Results】All laparoscopic operations were performed successfully without conversion to open surgery.Mean operative time was 45min （range 35 to 60min）,the estimated mean blood loss was 5 mL （range 2 to 10 mL）.No intraoperative complications occurred.During the postoperative follow-up of 3 to 6 months,mechanical obstruction complicated on 2 cases,catheter tip migration occurred 1 case,3 cases were observed pericatheter leak,and 1 case was complicated scrotum edema.【Conclusions】Compared with the tradilional techniques,laparoscopic placement of peritoneal dialysis catheters has the advantages of securing a dependent location and producing cosmetic results,It allows relatively early use of the Catheter for peritoneal dialysis and leads a shorter hospital stay.

关 键 词：腹膜透析管 腹腔镜 终末期肾病 

分 类 号：R612[医药卫生—外科学]