改良导管部分再植入技术在腹膜透析导管相关外出口感染中的应用  

Application for modified partial catheter re-implantation for peritoneal dialysis catheter-related infection

作　　者：郭姗姗 付纲[1] 张丽红[1] Guo Shan-shan;Fu Gang;Zhang Li-hong(Department of Nephrology,Beijing Haidian Hospital(Haidian Section of Peking University Third Hospital),Beijing 100080,China)

机构地区：[1]北京市海淀医院(北京大学第三医院海淀院区)肾脏内科,北京100080

出　　处：《临床肾脏病杂志》2023年第8期647-652,共6页Journal Of Clinical Nephrology

摘　　要：目的观察改良导管部分再植入技术治疗腹膜透析导管相关外出口感染的有效性及安全性。方法回顾性分析2010年1月至2020年4月因腹膜透析导管外出口感染经保守治疗无效就诊于北京市海淀医院行手术治疗的患者临床资料,按照手术方式分为导管完全更换组15例(对照组),改良导管部分再植入组18例(观察组),对比两组患者手术即刻成功率、手术相关并发症。并对入组患者随访2年,了解术后2年的导管存活情况、远期并发症情况。结果观察组与对照组手术即刻成功率均为100%,术中并发症发生率均为0。随访2年两组患者导管存活率分别为88.89%,100%,差异无统计学意义(P=0.489),2年中总并发症发生率分别为5.56%,13.33%,差异无统计学意义(P=0.579)。结论改良导管部分再植入技术用于处理保守治疗无效的腹膜透析导管相关外出口感染有效、安全,值得临床推广。Objective To observe the effectiveness and safety for modified partial catheter re-implantation for peritoneal dialysis catheter-related infection.Methods From January 2010 to April 2020,clinical data were reviewed for 33 surgical patients due to peritoneal dialysis catheter-related infection and a failure of conservative measures.According to surgical approaches,they were assigned into two groups of complete replacement peritoneal dialysis catheter(control,n=15)and peritoneal dialysis partial catheter re-implantation(observation,n=18).Immediate success rate and surgical-related complications were compared between two groups.The survival of catheters and long-term complications were recorded during a follow-up period of 2 years.Results Immediate success rate of operation was 100%in both groups and the incidence of intraoperative complications 0.The survival rate of catheterization was 88.89%and 100%in two groups without statistical difference(P=0.489).During 2-year observation period,total complication in two groups was 5.56%and 13.33%without statistical difference(P=0.579).Conclusions In patients with peritoneal dialysis catheter-relative infection not responding to conservative measures,modified partial catheter re-implantation is both safe and effective.It is worthy of wider clinical promotions.

关 键 词：腹膜透析 感染 导管 导管部分再植入技术 

分 类 号：R692.5[医药卫生—泌尿科学]