腹膜透析导管内固定术在降低导管移位中的应用  

The application of inner fixation of the peritoneal dialysis catheters to prevent its displacement

作　　者：朱吉莉[1] 王玉娟 陈星华[1] 丁国华[1] 王惠明[1] ZHU Jili;WANG Yu-juan;CHEN Xing-hua;DING Guo-hua;WANG Hui-ming(Department of Nephrology,Renmin Hospital of Wuhan University,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院肾内科

出　　处：《中国血液净化》2019年第11期742-744,共3页Chinese Journal of Blood Purification

摘　　要：目的导管功能不良,尤其是导管移位和梗阻是腹膜透析主要的非感染性导管并发症。研究者开发了一种新的外科技术,即在常规手术基础上对导管进行腹壁内固定,以避免这一情况的发生。方法对278例武汉大学人民医院肾内科终末期肾病患者进行回顾性研究,其中123例行传统的导管置入术(非固定组),155例次行导管置入术+内固定(固定组)。在固定组和非固定组之间,比较随访6个月内发生的腹膜透析导管相关感染、渗漏、入液疼痛、移位、包裹等非感染性并发症。结果内固定术手术无腹膜透析导管移位发生可能,非固定组导管移位发生率13.8%,固定组观察6个月未发生移位。结论透析导管内固定是降低腹膜透析非感染性导管并发症的有效方法,提高了腹膜透析早期导管技术生存率。Objective Malfunction of the peritoneal dialysis (PD) tubes, especially displacement and occlusion of the tubes, are the main factors for non-infective PD-tube complications. We developed a new surgical technology that fixes the tubes on the inner surface of abdominal wall to prevent the occurrence of these situations. Method This was a retrospective study involving 278 end-stage renal disease patients treated in the Department of Nephrology, Renmin Hospital of Wuhan University. The conventional surgery of PD-tube placement was used in 123 patients (non-fixation group), and PD-tube placement surgery plus inner fixation of the tubes was performed in 155 patients (fixation group). PD-tube related complications including infections, leakage, pain during dialysate infusion, tube displacement, and wrapped PD-tubes in the follow-up period of 6 months were compared between the two groups. Results In non-fixation group, the rate of tube displacement was 13.8%. In fixation group, the operation time was longer, no tube displacement occurred in the follow-up period of 6 months, and the early technical survival rate of PD-tubes became higher. Conclusion Inner fixation of the PD-tubes was effective to prevent the non-infective PD-tube complications, and the early technical survival rate of PD-tubes became higher.

关 键 词：腹膜透析 置管术 导管固定 

分 类 号：R459.5[医药卫生—治疗学]