腹腔镜术与开放式手术对腹膜透析管大网膜包裹腹腔感染的分析  

Clinical efficacies of laparoscopy and open surgery in treatment of omental wrapping of peritoneal dialysis tube peritoneal infections

作　　者：徐兵[1] 刘松杰[1] 陈智年[1] 窦启锋[2] 

机构地区：[1]新乡市中心医院普通外科,河南新乡453000 [2]新乡医学院第三附属医院泌尿外科,河南新乡453000

出　　处：《中华医院感染学杂志》2013年第24期6009-6011,共3页Chinese Journal of Nosocomiology

基　　金：河南省教育厅自然科学研究基金项目(2010B310003);河南省卫生厅科技基金项目(5451工程)

摘　　要：目的探讨腹腔镜术与开放式手术对腹膜透析管大网膜包裹的临床疗效及控制腹腔感染的相应措施,以降低术后腹膜透析管出口感染率。方法回顾性分析2010年5月-2012年10月医院住院治疗的终末期肾脏病患者伴发腹膜透析管大网膜包裹保守治疗无效的临床资料共22例,将其随机分为对照组与观察组,每组各11例,比较两组患者在不同治疗方式下的特点,术后感染等并发症及血肌酐、尿素氮的变化,采用SPSS 14.0软件进行统计分析,计量资料采用t检验以均数±标准差表示,计数率的比较采用χ2检验。结果观察组较对照组患者在手术时间、手术切口长度上明显占优,但手术费用较高,两组患者术后出现腹膜透析管出口感染患者分别为5、1例,血肌酐观察组(868.13±351.32)μmol/L、对照组(985.41±336.54)μmol/L;尿素氮观察组(17.12±7.88)mmol/L、对照组(19.23±6.31)mmol/L,两组比较差异有统计学意义(P<0.05)。结论腹腔镜较开放式手术疗效好,但手术费用过高,且腹腔镜手术操作复杂,操作不当易引起腹部感染等并发症,血必净联合抗菌药物对于腹腔感染效果值得肯定。OBJECTIVE To explore the clinical efficacies of laparoscopy and operation surgery in the treatment of omental wrapping of peritoneal dialysis tube peritoneal infections and put forward corresponding measures for the control of abdominal infections so as to reduce the incidence of postoperative peritoneal dialysis catheter outlet infections. METHODS The clinical data of 22 cases of end-stage renal diseases complicated with peritoneal dialysis tube omental wrapping who were invalid for conservative therapy were retrospectively analyzed, then the subjects were randomly divided into the control group and the observation group, with 11 cases in each; the characteristics under different therapies, incidence of complications such as postoperative infections, and change of the level of serum creatinine or blood urea nitrogen were observed and compared between the two groups, the statistical analysis was performed with the use of SPSS 14.0 software, the measurement data were analyzed by using the t-test, and the count data were analyzed with the use of chi-square test. RESULTS As compared with the control group, the observation group took advantages in the operation duration and the length of surgical incision, but the cost of surgery was high; there were 5 cases of postoperative peritoneal dialysis catheter outlet infections in the observation group and I case in the control group; the level of serum creatinine was （868.13±351.32） μmol/L in the observation group, （985.41±336.54）μmol/L in the control group; the level of blood urea nitrogen was （17.12 ± 7.88） mmol/L in the observation group, （19.23±6. 31） mmol/L in the control group, the differences between the two groups were statistically significant （P〈0.05）. CONCLUSION The laparoscopy is superior to the open surgery in the clinical efficacy, but the cost of the surgery is high, the procedures of the laparoscopy are complicated,improper operation may result in the complications such as the abdominal infections; the therapeutic effect of the X

关 键 词：腹腔镜 腹膜透析管 大网膜包裹 腹部感染 

分 类 号：R181.32[医药卫生—流行病学]