不同腹膜透析置管方法的临床对比研究  

THE COMPARISON OF DIFFERENT PLANTING IN PATIENTS WITH PERITONEAL DIALYSIS TUBE METHOD PLANTING

作　　者：闫骏[1] 赵建荣[2] 

机构地区：[1]内蒙古医学院附属医院泌尿外科,呼和浩特010050 [2]内蒙古医学院附属医院肾内科,呼和浩特010050

出　　处：《内蒙古医学院学报》2011年第4期295-298,共4页Acta Academiae Medicinae Neimongol

基　　金：内蒙古自治区人才开发基金(2008);内蒙古自治区高等学校科学技术研究项目(NJ10133)

摘　　要：目的:探讨不同腹膜透析(PD)置管方法在治疗急慢性肾功能衰竭时的手术方法及其注意事项。方法:在2008-12～2010-12入住我科的100例急、慢性肾衰竭病人,在不同手术方法下置入腹膜透析管,回顾总结两种置管方法的临床应用体会和注意事项。45例病人采取了解剖法置管,其中15例选用卷曲管,30例选用直型标准Tenckhoff腹膜透析管;55例病人采用解剖法联合腹壁悬挂术置管,其中20例选用卷曲管,35例使用直型标准Tenckhoff腹膜透析管,术后均使用百特双联系统装置进行腹透。结果:用两种手术方法成功植入腹膜透析管后,术后无论是立即作连续不卧床腹膜透析(CAPD),或是由间歇性腹膜透析(IPD)过渡到CAPD者均未出现手术切口及隧道口渗液、感染等。除2例病人未到拆线期死亡外,其余98例手术切口均一期愈合。解剖法置管的45例中,总漂管发生率15.5%,卷曲管1mo内腹透管漂移发生率为13.3%,经胃镜刷及体位变化复位未成功,直型标准管1mo内漂管发生率为16.6%,经胃镜刷及体位变化2例复位成功,3例仍引流缓慢。应用解剖法联合腹壁悬挂术置入的55例卷曲管和直型标准Tenckhoff腹膜透析管均未出现漂管。结论:腹透管的成功置入是腹透病人长期生存的基本前提,置管方法采用解剖法联合腹壁悬挂术置入直型管成功率高,术式简单,方法稳定,临床费用下降,值得推广。Objective： To investigate the different peritoneal dialysis（PD） surgical methods and precautions in the treatment of acute and chronic renal failure.Methods：100 cases of acute and chronic renal failure patients during the period from Dec.2008 to Dec.2010 were enrolled in this study.Peritoneal dialysis tubes were implanted under different surgical method.Two methods of clinical application of catheter experience and precautions were reviewed.45 patients were taken dissection tube,15 cases of them were selected coiled tube,but 30 patients were used the standard straight Tenckhoff peritoneal dialysis catheter.55 patients were combined with dissection and abdominal wall hanging catheter technique.20 cases of them were used coiled tube,but 35 patients were selected the standard straight Tenckhoff peritoneal dialysis catheter.The Baxter PD duplex system devices were used after operation.Results： After the peritoneal dialysis tubes were successfully implanted by two surgical methods,tunnel incision＇s effusion and infection have not been found either continuous ambulatory peritoneal dialysis（CAPD）,or by intermittent peritoneal dialysis（IPD） the transition to CAPD immediately after surgery.In addition to 2 cases were dead until they didn＇t reach suture removal,the remaining 98 cases of surgical incision healed.45 cases were taken dissection tube,tube drift rate was 15.5%.15 cases were used curled tube and 30 cases were used the standard straight Tenckhoff peritoneal dialysis catheter,In a month,13.3% cases used the coil tube occurred tube drift.The reset is not successful by endoscopic brush and position changes.But 16.6% cases used the standard straight Tenckhoff peritoneal dialysis catheter occurred tube drift.2 cases are successful reduction by endoscopic brush and position changes,Although 3 patients are still draining slowly.55 cases who used straight tube and coiled tube and converted to dissection into the joint operation of abdominal wall hanging did not appear float tube.Conclusion：Whether

关 键 词：腹膜透析 解剖法置管 腹壁悬挂术 

分 类 号：R692.5[医药卫生—泌尿科学]