采用垂直律动技术改善导管移位所致腹膜透析液引流障碍临床疗效探讨  

Clinical observation on the effect of vertical pulse to improve dialysate drainage disorder due to catheter displacement

作　　者：王吉[1] 朱楠 于青[2] 费海平 姚洁[1] WANG Ji;ZHU Nan;YU Qing;FEI Hai-ping;YAO Jie(Department of Nursing,the First Affiliated Hospital,Shanghai Jiaotong University,Shanghai 201620,China;Department of Nephrology,the First Affiliated Hospital,Shanghai Jiaotong University,Shanghai 201620,China)

机构地区：[1]上海交通大学附属第一人民医院护理部,上海201620 [2]上海交通大学附属第一人民医院肾内科,上海201620

出　　处：《中国血液净化》2020年第6期381-384,共4页Chinese Journal of Blood Purification

基　　金：上海交通大学医工交叉基金(项目编号:YG2016QN27);上海市卫计委青年项目(项目编号:20164Y0234);上海交通大学附属第一人民医院课题(02.06.01.19.59)。

摘　　要：目的探讨垂直律动改善导管移位相关腹膜透析液引流障碍的临床效果。方法选取2017年5月~2019年5月上海交通大学附属第一人民医院肾内科收治的规律腹膜透析(peritoneal dialysis,PD)伴引流障碍患者,行立位腹部平片确诊为PD导管移位22例,利用垂直律动仪的高频低振幅振动治疗,记录治疗疗程及前后患者24h超滤量,评估腹膜透析液引流速度,并复查腹部平片判断导管复位情况。结果22例PD导管移位患者中,垂直律动治疗后腹膜透析液引流速度较前平均增快59.317ml/min[(80.284±26.079)ml/min比(20.931±7.366)ml/min,t=10.656,P<0.001];其中3例患者导管复位至真骨盆;17例患者导管末端位置下降1~2个椎体水平,2例患者透析液引流障碍未改善。结论垂直律动治疗操作简单,能有效改善导管移位相关透析液引流障碍,值得在临床上推广应用。Objective To investigate the clinical effect of vertical rhythm on ameliorating dialysate drainage disorder due to catheter displacement in peritoneal dialysis(PD)patients.Methods A total of 22 PD patients treated in the Department of Nephrology,the First Affiliated Hospital of Shanghai Jiaotong University from May 2017 to May 2019 were recruited.These patients complied with the diagnosis of drainage barrier due to PD catheter displacement confirmed by stand abdominal X-ray plain film.We used the vertical rhythm instrument with high frequency and low amplitude vibration to treat the patients.Their 24-hour ultrafiltration volume before and after the treatment was recorded,PD fluid drainage speed was assessed,and the place of PD catheters was rEexamined by abdominal X-ray plain film.Results Among the 22 PD patients with catheter displacement,the average drainage rate of the outflow fluid increased by 59.317 ml/min(80.284±26.079) ml/min vs.20.931±7.366 ml/min(t=10.656,P<0.001)after vertical rhythm treatment.The place of PD catheters restored to the true pelvis in 3 cases;the tips of PD catheters moved down 1-2 vertebra levels in 17 cases and the drainage disorder remained in 2 cases.Conclusion The vertical rhythm therapy is simple to operate and can effectively improve the obstruction of dialysis fluid drainage caused by catheter displacement.This method is worthy of clinical use.

关 键 词：垂直律动 导管移位 腹膜透析引流障碍 

分 类 号：R45[医药卫生—治疗学]