直型与卷曲型鹅颈腹膜透析导管的临床应用  

Evaluation of different type swan-neck dialysis catheters on patients with peritoneal dialysis

作　　者：周岩[1] 李建东[1] 周婷婷[1] 王好[1] 李世军[1] 唐政[1] 刘志红[1] 俞雨生[1] 

机构地区：[1]南京军区南京总医院全军肾脏病研究所,南京210002

出　　处：《肾脏病与透析肾移植杂志》2011年第3期240-242,279,共4页Chinese Journal of Nephrology,Dialysis & Transplantation

摘　　要：目的:对比观察不同类型鹅颈腹膜透析(PD)导管的性能及可能引起的并发症,探讨不同导管的最佳适应证。方法:回顾性分析2007年3月至2010年2月在南京军区南京总医院全军肾脏病研究所行PD置管手术患者358例,按置入导管种类的不同分为鹅颈直管组及鹅颈卷曲管组。两组患者随访时间均大于3个月。观察两组患者的透析液流量、导管移位、隧道感染、出口感染、PD液渗漏等发生情况。结果:直管组231例,卷曲管组127例,两组患者的年龄、原发病情况无差别,两组患者PD隧道感染率和出口感染率无差别(P>0.05)。直管组患者出现导管移位7例(3.0%),而卷曲管组多达26例(20.4%),两组相比有显著性差异(P<0.01);且鹅颈直管自行复位率高,需要重新置管的患者较少。另外发现以耻骨联合上11cm定位的直管移位率低。结论:不同类型鹅颈导管各有优缺点,相比直管,卷曲管导管移位率较高。Objective：To compare the effects of different types of swan-neck dialysis catheter performance and complications in patients with peritoneal dialysis and explore the indications for different catheter. Methodology：From March 2007 to February 2010, three hundred and fifty eight patients with ambulatory peritoneal dialysis were retrospeclively investigated. According to the different types of the catheter, they were divided into two groups ： swan-neck straight （ n = 231 ） and coiled （ n = 127 ） group. Two groups of patients were followed up for more than three months. The dialysate flow rate, catheter dislocation, tunnel infection, exit infection, and the incidence of dialysate leakage were observed. Results ： There was no difference in age and primary disease of two groups ; and also no difference in dialysate exit infection and tunnel rate infection （ P 〉 0. 05 ）. The catheter displacement occurred in 7 cases （ 3.0% ） of straight group while in as many as 26 cases （20.4%） of the coiled group, and it was significant difference between two groups （P 〈 0. 01 ）. The self：reset rate, need to re-catheterization in swan-neck straight patients was less. In addition to swan-neck straight, the dislocation rate was low when the pubic symphysis 11 em as a location mark. Conclusion ： The different types of swan-neck catheters have advantages and disadvantages, swan-neck coiled catheter displacement rate is high, it is not suitable for Chinese patients with ESRD.

关 键 词：腹膜透析 置管术 鹅颈导管 

分 类 号：R459.5[医药卫生—治疗学]