腹透外接短管非常规更换的原因分析与预防  

Causes and Prevention of Irregular Replacement of External Short Tube in Peritoneal Dialysis Patients

作　　者：徐春华[1] 廖玉梅[1] 高敏[1] 何艳[1] 

机构地区：[1]北京大学深圳医院肾内科,广东深圳518036

出　　处：《实用临床医学（江西）》2016年第3期76-79,共4页Practical Clinical Medicine

基　　金：深圳市医疗卫生系统2009年科技计划资助项目(200902059)

摘　　要：目的分析导致腹膜透析患者发生非常规更换腹透外接短管的原因,并探讨预防对策。方法回顾性分析544例腹膜透析患者发生非常规换管的原因,比较发生非常规换管与患者性别、年龄、文化程度、腹膜透析操作者、随访情况、医疗付费方式等的关系。结果 544例患者中是否发生非常规换管患者的文化程度、年龄比较差异有统计学意义(均P=0.000<0.05),其中发生非常规换管144例,其原因主要为短管头污染(63.89%,92/144);透析龄6个月内者发生率最高占43.75%(63/144);不同透析龄间的非常规换管原因比较差异无统计学意义(χ2=7.568、P=0.271)。结论发生非常规换管的原因主要为短管头污染,其次为腹透管破损和短管脱落,是否发生非常规换管与患者年龄、文化程度有关。对腹透患者要进行全程监管,置管后不仅要对患者及操作者进行系统、规范的理论操作培训考核,还应定期进行理论操作再培训,尤其应加强腹透置管出院前老年患者的自身操作培训,重视管路的连接和保护,以减少非常规换管的发生。Objective To analyze the reasons for irregular replacement of external short tube in peritoneal dialysis patients,and to explore the prevention countermeasures.Methods Reasons for irregular replacement of external short tube were analyzed retrospectively in 544 peritoneal dialysis patients.The relationships of irregular tube replacement to the gender,age,education level,peritoneal dialysis operators,follow-up situation and medical payment methods were analyzed.Results There were significant differences in education level and age between patients who underwent irregular tube replacement and patients who did not undergo irregular tube replacement（P=0.000）.Short tube tip pollution was the main reason for irregular external short tube replacement（63.89%,92/144）,which occurred most frequently within 6 months of dialysis（43.75%,63/144）.No significant differences in reasons for irregular tube replacement were found among different dialysis durations（χ2=7.568,P=0.271）.Conclusion The main reason for irregular external short tube replacement is short tube tip pollution,followed by peritoneal tube breakage and short tube detachment.The occurrence of irregular tube replacement is correlated with the age and education level.Peritoneal dialysis patients should be supervised thoroughly.After catheterization,systematic and standardized training and examination of theory and operation should be performed at regular intervals in patients and operators,especially in elderly patients before discharge.In addition,the connection and protection of tube should be emphasized to reduce the occurrence of irregular tube replacement.

关 键 词：腹膜透析 外接短管 原因 对策 

分 类 号：R473.5[医药卫生—护理学]