腹膜透析置管手术改进及临床效果观察  

Clinical implementary of the improved peritoneal dialysis catheters

作　　者：张莉[1] 任海滨[1] 毛慧娟[1] 王宁宁[1] 俞香宝[1] 孙彬[1] 张波[1] 洪惠萍[1] 黄抱娣 邢昌赢[1] 刘佳[1] 

机构地区：[1]南京医科大学第一附属医院肾内科,南京210029

出　　处：《肾脏病与透析肾移植杂志》2013年第6期535-537,共3页Chinese Journal of Nephrology,Dialysis & Transplantation

基　　金：江苏省医学领军人才与创新团队;医学重点人才资助基金

摘　　要：目的:总结本中心首创的改良腹膜透析(PD)置管术式——低位-直管模拟鹅颈隧道成型置管术。方法:收集南京医科大学第一附属医院肾内科2008年10月至2012年2月采用该改良PD置管手术行PD治疗的病例资料。结果:共收集手术病例153例,平均年龄为57.1±18.8岁,平均随访时间15.5±11.3月。其中发生漂管而需要重新手术置管1例;腹膜炎58例次,发生率为40.34个患者月;出口感染16例次,发生率为146.3个患者月,隧道感染5例次,发生率为468个患者月;无大网膜包裹病例,均无膀胱损伤、切口疝和肠管损伤。结论:该PD置管术式具有漂管率和大网膜包裹率低的优势,减少了患者因导管机械性故障而导致的再次手术,同时具有较低的出口和隧道感染率。Objective：To introduce and evaluate an improved catheter implantation technique for peritoneal dialysis （PD） patients.Methodology：One hundred and fifty three patients undergoing improved catheter implantation in our center from Oct 2008 to Feb 2012 were respectively analyzed.The improved catheter implantation technology was characterized by low site and inverse-U-shaped tunnel.The incidence of catheter migration and exit-site infection were investigated.Results：There were no patients with experiencing catheter omentum obstruction and developing incisional hernia.Only one of them （0.6％） had catheter tip migration and surgical revision was needed.During the follow-up period,58 episodes of peritonitis and 16 episodes of exit-site infection were observed,with a mean incidence of 1/40.34 and 1/146.3 patient-months respectively.Conclusion：The improved implantation of the PD catheter can reduce the incidence of the technical failure and PD-related complications and improve the dialysis quality.

关 键 词：腹膜透析 并发症 置管 手术 

分 类 号：R459.5[医药卫生—治疗学]