应用扇形拨开器与常规置管术在腹膜透析置管中的效果比较  

An analysis and comparison of the two methods for implanting peritoneal dialysis catheters

作　　者：李玉斌[1] 全昌银[2] 闫翠萍[1] 李书会[1] 刘兰香[1] 陈飞[1] 李六生[1] 谢希[1] 

机构地区：[1]三峡大学人民医院肾内科,湖北宜昌443000 [2]三峡大学人民医院普外科,湖北宜昌443000

出　　处：《中国血液净化》2013年第4期180-183,共4页Chinese Journal of Blood Purification

摘　　要：目的比较应用扇形拨开器的腹膜透析(peritoneal dialysis,PD)置管术与常规PD置管术术后引起的并发症,探讨应用扇形拨开器的PD置管术的临床效果。方法随机入选三峡大学人民医院肾内科2009年2月至2012年4月首次PD置管并接受PD治疗且观察满6个月的终末期肾病(end stage renal disease,ESRD)患者共69例,随机分为用扇形拨开器引导组(A组),常规手术组(B组),A组35例,B组34例,纪录2组术前的基本情况、术后感染并发症;同时观察比较2组术后6个月内的PD管移位率、导管阻塞率、渗漏、疼痛等机械并发症发生情况。结果 2组患者的年龄、原发病情况无差别(P>0.05);A组患者导管移位3例(8.57%),B组患者导管移位10例(29.41%),两组相比有显著性差异(÷2=4.899,P=0.027);A组患者重新置管2例(5.71%),B组患者重新置管8例(23.53%),2组相比有显著性差异(÷2=4.417,P0.036);2组患者发生导管阻塞、渗漏、疼痛等并发症差异均无统计学意义(P>0.05)。2组患者发生感染并发症无统计学差异(P>0.05)。结论应用扇形拨开器的PD置管术可降低置管术后PD导管移位率,需重新置管率低。不增加PD置管术后感染率及机械并发症。Objective To explore the clinical effect of the improved method for insertion of peritoneal dialysis （PD） catheters in patients with end-stage renal disease （ESRD）. Methods From February 2009 to April 2012, sixty-nine ESRD patients who needed catheterization for PD were prospectively and randomly divided into two groups, group A （improved method, using the sector dispelling apparatus to guide PD catheter insertion, n=35） and group B （conventional method for PD catheter insertion, n=34）. Clinical data at baseline and follow-up information were collected. Complications including catheter dislocation, obstruction, leakage and pain were compared between the two groups. Results At the baseline, clinical conditions including age and primary disease had no differences between the two groups （P 〉 0.05）. No differences in superficial infection and tunnel infection around the catheter （χ^2=4. 899, P 〉 0.05）, catheter obstruction, leakage and pain were found between the two groups （χ^2=4.417, P 〉 0.05）. Catheter dislocation occurred in 3 cases （8.57%） in group A and 10 cases （29.41%） in group B （P〈0.05）. Re-insertion of the catheter was performed in 2 cases （5.71%） in group Aand in 8 cases （23.53%） in group B （P 〈0.05）. Conclusion The improved method for insertion of PD catheters can reduce the rates of catheter dislocation and re-insertion without increase of infection and complication due to mechanical injuries.

关 键 词：腹膜透析 扇形拨开器 置管术 并发症 

分 类 号：R459.5[医药卫生—治疗学]