四种冲洗方式预防腹膜透析早期导管移位效果比较  

Comparison of effects of four lavage methods on prevention of catheter displacement in early stage of peritoneal dialysis

作　　者：黄静[1] 林莉[1] 张红[1] 谢香成[1] 

机构地区：[1]中国人民解放军总医院肾脏病科,北京100853

出　　处：《护理学杂志》2014年第11期7-9,共3页

摘　　要：目的降低腹膜透析置管术后早期导管移位发生率。方法将56例首次行腹膜透析置管术患者随机分为四组,均于置管术后第1天使用1.5%乳酸盐腹膜透析液200mL进行腹腔冲洗,每日2次,连续7d。A组(14例)采用卧位、重力方式冲洗;B组(15例)立位、重力冲洗;C组(13例)卧位、脉冲式冲洗;D组(14例)立位、脉冲式冲洗。结果四组导管位置评分比较,差异有统计学意义,D组评分显著优于其他三组(均P<0.05);四组腹腔冲洗时疼痛评分比较,差异无统计学意义(P>0.05);四组均无腹腔出血、感染等并发症发生。结论立位联合脉冲式腹腔冲洗能够减少腹膜透析置管术后早期导管移位,且不会增加患者疼痛。腹膜透析置管术后早期,在没有禁忌证的情况下,应尽可能采用站立体位和脉冲式推注的方式进行腹腔冲洗。Objective 1 o reduce me lnClctence oi catneter displacement in early stage of peritoneal dialysis. Methods Fifty-six new peri- toneal dialysis patients receiving peritoneal lavage with 200 mL 1.5 % lactated peritoneal dialysis solution were randomly assigned to one of four groups： group A （n = 14） ,lying position and gravity-assisted lavage; group B （n= 15）, standing position and gravi- ty-assisted lavage; group C （n= 13）, lying position and pulsatile lavage; and group D （n= 14）, standing position and pulsatile lavage. The lavage was performed twice a day for 7 consecutive days. Results There was statistical difference in scores of the cathe- ter tip position among the four groups, with group D significantly lower than the other 3 groups （P〈0.05 for all）. The pain inten- sity scores during lavage showed no significant difference among the four groups （P〉0.05）. None of patients in the four groups developed peritoneal bleeding and infection. Conclusion Pulsatile lavage performed in standing position could reduce catheter dis- placement in early stage of peritoneal dialysis without increasing subjective pain intensity, which is recommended for patients without contraindications.

关 键 词：腹膜透析 导管移位 腹腔冲洗 卧位 立位 脉冲式 并发症 

分 类 号：R47[医药卫生—护理学] R459.5[医药卫生—临床医学]