摘要
目的观察改良的腹膜透析(peritoneal dialysis,PD)导管固定方法在PD置管术中的应用。方法收集2014年6月至2019年6月在扬州大学医学院附属泰兴市人民医院肾脏内科确诊为终末期肾病并选择PD治疗的大于18岁的患者,随机分为常规手术组与改良腹壁固定组,随访6个月,比较两组患者手术用时,术后导管漂管、网膜包裹、腹透液渗漏、疝气、血性腹水、腹膜炎、腹腔脏器损伤、切口感染或愈合不良发生率。结果共120例患者入组,两组各60例。两组患者性别、年龄、身高、体重、体重指数、体表面积、肌酐、尿素、肾小球滤过率、白蛋白以及血红蛋白水平比较均无差异。随访6个月,两组患者均未出现腹腔脏器损伤、腹透液渗漏、血性腹水、切口感染或愈合不良。两组患者手术时间、腹膜炎发生率、疝气发生率差异无统计学意义(P>0.05),但改良腹壁固定组无1例患者发生漂管及大网膜包裹,常规手术组发生了7例漂管,6例网膜包裹,两组差异具有统计学意义(P<0.05)。结论改良的PD导管固定方法可降低PD患者的漂管率及网膜包裹率,不增加手术时间及其他并发症,简易可行,值得基层医院推广使用。
Objective To observe the application of improved fixation of peritoneal dialysis(PD)during PD catheterization.Methods From June 2014 to June 2019,a total of 120 end-stage renal disease patients on PD aged above 18 years were randomly divided into two groups of traditional and improved abdominal wall fixation(n=60 each).During a follow-up period of 6 months,catheter related complications were compared.Results No inter-group differences existed in gender,age,height,weight,body mass index,surface area,creatinine/urea level,glomerular filtration rate or albumin/hemoglobin level.None of them had an onset of abdominal visceral injury,bloody ascites,fluid leakage,surgical incision infection or poor healing.No inter-group differences existed in operative duration,incidence of peritonitis or hernia(P>0.05).The rates of catheter drift and greater omentum packaging were high in traditional group than those in abdominal wall fixation group(P<0.05).Conclusion Improved PD fixation may reduce the odds of PD catheter malfunction.
作者
张锁建
章旭
曹娟
周长菊
许琴
李海涛
Zhang Suo-jian;Zhang Xu;Cao Juan;Zhou Chang-ju;Xu Qin;Li Hai-tao(Taixing People's Hospital affiliated Yangzhou university medical college,Taixing 225400,China)
出处
《临床肾脏病杂志》
2021年第3期210-214,共5页
Journal Of Clinical Nephrology
关键词
腹膜透析
导管固定
漂管
Peritoneal dialysis
Catheter fixation
Catheter drift
