两种不同腹膜透析导管拔除术在老年腹膜透析患者中的临床应用  

Clinical evaluation of two different peritoneal dialysis catheter removal methods in elderly patients on peritoneal dialysis

作　　者：张圣雪[1] 苏晓乐[1] 闫燕[1,2] 赵彦 刘新艳 李晓霞[1] 张艳 王利华[1,2] Zhang Shengrue;Su Xiaole;Yan Yan;Zhao Yan;Liu Xinyan;Li Xiaoxia;Zhang Yan;Wang Lihua(Department of Nephrology,the Second Hospital of Shanri Medical University,Taiyuan 030001,China;Center of Blood Purification Management and Medical Quality Control,Health Commission of Shanxci Province,Taiyuan 030001,China)

机构地区：[1]山西医科大学第二医院肾内科,太原030001 [2]山西省卫生健康委血液净化管理医疗质量控制中心,太原030001

出　　处：《中华老年医学杂志》2022年第2期191-195,共5页Chinese Journal of Geriatrics

摘　　要：目的分析两种腹膜透析导管拔除术在老年腹膜透析患者中的应用情况。方法采用回顾性队列研究的方法,收集2010年8月至2020年5月于山西医科大学第二医院腹膜透析中心移除腹膜透析导管的107例老年腹透患者的临床资料,分为外科开放式拔管组(外科组)和"pull"技术拔管组(pull组),比较两组性别、年龄,原发病,透析龄﹑拔管原因及术前相关化验等指标,观察两组手术时间、术后住院时间、手术疼痛程度及术后并发症等相关情况。结果外科组的手术时间[(71.2±13.4)min和(19.3±5.6)min,t=16.933,P<0.011].术后住院时间[(9.5±1.8)d和(2.2±0.5)d,t=10.988,P≤0.01]和术中疼痛评分[(4.4±1.6)分和(1.4±1.1)分,t=6.909,P<0.01]及术后24 h的疼痛评分[(3.7±l.4)分和(0.5±0.3)分,t=9.995,P<0.01]均高于pull组,两组术后并发症发生率(6.8%和5.0%,x^(2)=0.037,P>0.05)差异无统计学意义。结论外科开放式手术法和"pull"技术拔管法均可安全有效的拔除老年腹透患者的腹透导管,其中"pull"技术拔管法的创伤小、手术快、易操作,有利于提高老年腹膜透析患者的生存质量。Objective To assess two methods for peritoneal dialysis catheter removal in elderlypatients on peritoneal dialysis.Methods A retrospective cohort study was conducted and clinicaldata were collected for 107 elderly patients on peritoneal dialysis with catheters removed at theperitoneal dialysis center of the Second Hospital of Shanxi Medical University from August 2010 toMay 2020.The 107 patients were divided into the open surgical extubation group and the ‘pull'technique group.Sex,age,disease leading to dialysis,dialysis age,reason for extubation andpreoperative test results were compared between the two groups.Operative time,length ofpostoperative hospitalization,perioperative pain and postoperative complications of the two groupswere examined.Results Higher levels or values were observed in operative time[(71.2±13.4)minzs.(19.3±5.6)min,t=16.933,P<0.01],length of postoperative hospitalization[(9.5±1.8)d vs.(2.2±0.5)d,t=10.988,P<0.0l]and intraoperative pain score(4.4±1.6 vs.1.4±1.1,t=6.909,P<0.01)and pain score 24h after surgery(3.7±l.4 vs.0.5±0.3,t=9.995,P<0.01)in the opensurgical extubation group than in the pul technique group,but there was no statistical difference in theincidence of postoperative complications between the two groups(6.8%6 vs.5.0%,x^(2)=0.037,P>0.05).Conclusions either the open surgical removal method or ‘pull’technique.can safely andeffectively remove the peritoneal dialysis catheter in elderly patients on peritoneal dialysis of the twomethods,the pull technique has advantages including less trauma,shorter and simpler surgery,helpingachieve improved quality of life for elderly patients on peritoneal dialysis.

关 键 词：腹膜透析 腹膜透析拔管术 

分 类 号：R692.5[医药卫生—泌尿科学]