三导丝联合技术在腹透管移位后复位中的临床应用  

Clinical application of three-guide-wire technique in the reduction of the displaced peritoneal dialysis catheter

作　　者：梁君 吴晓东 张希旺 丁胜军 王卫东[3] LIANG Jun;WU Xiaodong;ZHANG Xiwang;DING Shengjun;WANG Weidong(Department of Oncology,Huishan District Traditional Chinese Medicine Hospital,Wuxi,Jiangsu Province 214177,China)

机构地区：[1]无锡市惠山区中医医院肿瘤科,江苏无锡214177 [2]无锡市惠山区人民医院肿瘤介入科 [3]无锡市人民医院介入科

出　　处：《介入放射学杂志》2023年第7期647-650,共4页Journal of Interventional Radiology

摘　　要：目的 探讨三导丝联合技术在严重移位的腹膜透析管复位中的应用价值。方法 选取10例腹膜透析管严重移位的患者,先采用重力复位、导泻复位、单导丝和双导丝复位等方法进行复位,失败后,采用三导丝联合技术,利用导丝各段硬度不同、表面涂层不同而产生的不同张力,并通过适当塑形增加移位透析管指向盆腔的弹力张力,分次、分段进行复位。结果 10例腹膜透析管严重移位至近肝区或左中上腹部,且有明显成角的患者,通过三导丝联合技术均成功复位至盆腔。2例患者复位后35 d、4个月后透析管再次发生严重移位,利用三导丝联合技术再次复位成功。所有患者复位后透析流量均恢复正常。在复位操作中和复位术后,所有患者均未发生腹痛、血腹等不良反应和并发症。结论 三导丝联合技术加强了透析管复位的弹性张力,用于严重移位腹膜透析管的复位成功率高,且无创、简便易行,值得临床推广。Objective To discuss the application value of three-guide-wire technique in the reduction of severely displaced peritoneal dialysis catheter.Methods Ten patients with severely displaced peritoneal dialysis catheter were enrolled in this study.At first,gravity reduction,catharsis reduction,single-wire and double-wire reduction were tried one by one to make the reduction of catheter,then,if the above methods failed,the three-guide-wire technique was employed for the reduction of catheter.By utilizing the different stiffness of each section of the guide-wire as well as the different tensions produced by different surface coatings,and at the same time through properly shaping the curvature of the catheter so as to increase the elastic force of the displaced peritoneal dialysis catheter onto the pelvic cavity,the reduction of the catheter was step by step and segment by segment carried out.Results In 10 patients,whose peritoneal dialysis catheters were severely displaced to the hepatic region or left upper abdomen with obvious angulation of the catheter,the catheter was successfully reset to the pelvic cavity with the help of three-guide-wire technique.Two patients experienced a severe displacement of the dialysis catheter again at 35 days and 4 months after reduction respectively,and the catheter was successfully reset again by using the three-guide-wire technique.All patients had a normal dialysis blood flow after catheter reduction.None of the patients had adverse reactions or complications such as abdominal pain,hemoperitoneum,etc.Conclusion The three-guide-wire technique can enhance the elastic tension of the dialysis catheter,and this technique has a high success rate for the reduction of severely displaced peritoneal dialysis catheter,besides,it is non-invasive,technically simple and easy to operate,therefore,it is worthy of clinical promotion.

关 键 词：三导丝联合技术 腹膜透析管移位 弹性张力 复位 介入技术 

分 类 号：R692.5[医药卫生—泌尿科学]