先期人工液腹在经皮腹膜透析置管中的运用  

Application of pre-stage artificial fluid abdomen in percutaneous peritoneal dialysis catheterization

作　　者：谢祖刚 陈晴 陈龙庚 陈梅梅 石相雅 Xie Zu-gang;Chen Qing;Chen Long-geng;Chen Mei-mei;Shi Xiang-ya(Department of Nephrology,Longyan People's Hospital,Longyan 364000,China)

机构地区：[1]龙岩人民医院肾病学科,龙岩364000

出　　处：《临床肾脏病杂志》2023年第1期6-11,共6页Journal Of Clinical Nephrology

摘　　要：目的 探讨先期人工液腹模式在Seldinger法经皮腹膜透析管置入术中的运用,并观察该术式优劣及并发症情况。方法 回顾性研究2020年6月至2021年9月在福建省龙岩人民医院肾病科住院行Seldinger法经皮腹膜透析管置入的39例患者资料,所有患者术前均在床边彩色多普勒超声下置入输液用中心静脉导管并输入液体1000~1500 mL,留置2~3 h后送患者入手术室,用导丝法把已经置入输液用的导管换成腹膜透析导管。观察先期液腹后换用腹膜透析导管的手术指标及术后3个月并发症情况。结果 39例患者全部顺利置入腹膜透析导管,手术即时成功率100%,无改行开腹病例;无内脏损伤病例;手术室中操作时长(15.1±2.3) min;术口长度(2.1±0.5) cm;术中出血量(14.1±1.8) mL,均未见血性腹透液颜色;导管异位3例(7.7%);腹膜炎1例(2.6%),未见渗漏;术后3个月导管功能均正常,术后到出院的时间(6.1±1.2) d。结论 先期人工液腹Seldinger腹膜透析置管法手术操作简单、安全、快速、舒适,术中及术后相关并发症明显减少。适用于早期开展经皮腹膜透析管置入及基层医院推广腹膜透析置管术。Objective To explore the application of pre-stage artificial liquid abdomen mode in percutaneous peritoneal dialysis catheterization with Seldinger method and observe the pros and cons of this operation and its complications.Methods From June 2020 to September 2021,39 patients were placed with percutaneous abdominal dialysis tubes by Seldinger method.Through a bedside ultrasound, a central intravenous catheter was inserted for an infusion of 1000-1500 mL liquid.They were transported into operating room after 2-3 hours of indwelling.And catheter was replaced by a peritoneal dialysis catheter by guide wire method.Surgical indicators of switching to peritoneal dialysis catheters in early stage of fluid post-abdominal switching and complications in postoperative 3 months were observed.Results All 39 patients were successfully placed with peritoneal dialysis catheter with an immediate success rate of 100%.There was no instance of open abdomen or visceral injury;operative duration(15.1±2.3) min;length of surgical opening(2.1±0.5) cm;intraoperative hemorrhagic volume(14.1±1.8) mL,none of which saw bloody abdominal dialysis color;there were catheter ectopia(n=3,7.7%)and peritonitis(n=1,2.6%),no leakage;normal catheter function within 3 months post-operation and time from postoperative to discharge(6.1±1.2) days.Conclusion Pre-stage artificial fluid abdominal Seldinger peritoneal dialysis catheterization is simple, safe, fast and comfortable.And the complications related to intraoperative and postoperative surgery are significantly minimized.It is suitable for early percutaneous peritoneal dialysis catheterization and promotion of peritoneal dialysis catheterization at primary hospitals.

关 键 词：先期液腹 导管 留置 腹膜透析 

分 类 号：R692.5[医药卫生—泌尿科学]