置管7天内启动腹膜透析患者的预后分析  

Patients initiated peritoneal dialysis within 7 days after peritoneal catheterization

作　　者：陈艺方 陈秀玲[3] 高辉[3] 王君如[3] 尹丽娟[3] 周勤[3] 李怡[3] 李贵森 陈瑾[1,3] CHEN Yifang;CHEN Xiuling;GAO Hui;WANG Junru;YIN Lijuan;ZHOU Qin;LI Yi;LI Guisen;CHEN Jin(Southwest Medical University,Luzhou 646000,China;Sichuan Provincial Building Hospital,Chengdu 610000,China;Sichuan Provincial People's Hospital,Chengdu 610000,China)

机构地区：[1]西南医科大学,泸州646000 [2]四川省建筑医院 [3]四川省人民医院

出　　处：《肾脏病与透析肾移植杂志》2022年第1期33-38,共6页Chinese Journal of Nephrology,Dialysis & Transplantation

基　　金：四川省科技厅课题(2017YSKY0001);四川省重点研发项目(2019YFS0538);四川省肾脏病临床研究中心项目(2019YFS0538)。

摘　　要：目的:探讨置管后7d内启动腹膜透析(PD)的安全性及预后。方法:本研究回顾性分析了四川省人民医院PD中心2008-01-01~2016-12-31的腹膜置管后早期启动PD患者的并发症及导管存活情况,随访3年。根据置管后开始PD时间将患者分为三组,P1组(≤7d)、P2组(8~13d)、P3组(≥14d)。所有患者均使用相同的PD起始剂量。研究的主要终点为导管技术失败,次要终点包括与PD相关的并发症及死亡。结果:本研究纳入437例患者,其中P1组163例、P2组189例、P3组85例。三组的1年和3年技术存活率分别为95.7%、92.6%、87.1%和94.5%、89.9%、85.9%(P=0.066)。三组的1年和3年患者生存率分别为90.2%、94.2%、97.6%和81.0%、82.5%、85.9%(P=0.595)。三组间围手术期并发症、感染并发症、导管通畅率、导管移位率无统计学差异。结论:置管术后7 d内启动PD患者与延迟开始透析者的导管技术存活率、患者生存率及PD相关并发症均无统计学差异,提示在置管后7 d内启动PD可作为常规治疗方式。Objective:This study observed the safety and prognosis of early initiation(7 days)of peritoneal dialysis(PD)after catheterization.Methodology:This study retrospectively analyzed the complications and catheter survival of patients who underwent PD early after peritoneal catheterization in our center from January 1,2008 to December 31,2016.The average follow-up time was 3 years.According to the time of started PD after catheterization,the patients were divided into three groups:P1(≤7 days),P2(8~13 days)and P3(≥14 days).All patients used the same starting dose of PD.The primary end point of study was catheter technical failure,the secondary end points included PD related complications and death.Results:437 patients were included,including 163 cases in P1 group,189 cases in P2 group and 85 cases in P3 group.The 1-year and 3-year technical survival rates in P1,P2 and P3 groups were 95.7%,92.6%and 87.1%;94.5%,89.9%and 85.9%,respectively(P=0.066).The 1-year and 3-year patient survival were 90.2%、94.2%、97.6%and 81.0%、82.5%、85.9%,respectively(P=0.595).There were no significant differences in perioperative complications,infective complications or catheter displacement rates among the three groups.Conclusion:Patients initialed PD within 7 days after catheterization were similar to patients with delayed dialysis initiation in technique survival,patient survival and PD related complications.

关 键 词：终末期肾病 腹膜透析 早期腹膜透析 技术存活率 

分 类 号：R692.5[医药卫生—泌尿科学]