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透视引导下腹膜透析导管置入术:单中心长期结果

Fluoroscopically guided peritoneal dialysis catheter placement: long-term results from a single center.

作者信息

Moon Ju-Young, Song Sebin, Jung Kyung-Hwan, Park Mina, Lee Sang-Ho, Ihm Chun-Gyoo, Oh Joo-Hyeong, Kwon Se Hwan, Lee Tae Won

机构信息

Internal Medicine, East-West Neo Medical Center of Kyung Hee University, #1 Hoeki-dong, Dongdaemun-Ku, Seoul, Republic of Korea.

出版信息

Perit Dial Int. 2008 Mar-Apr;28(2):163-9.

Abstract

OBJECTIVE

Despite percutaneous fluoroscopy ensuring appropriate placement of peritoneal dialysis (PD) catheters, the efficacy of this method is not well known. Therefore, we evaluated our long-term experience with fluoroscopy-assisted placement of PD catheters.

PATIENTS AND METHODS

We retrospectively reviewed 134 PD catheters in 114 PD patients that were treated in the PD center of a university-based hospital. We evaluated complications related to PD catheters, causes for catheter removal, and catheter survival. We used the multivariate Cox proportional hazard model to identify independent factors related to PD catheter survival.

RESULTS

Early complications related to insertion included 1 case of pericatheter bleeding; there were no placement failures. Early complications occurred in 8.5% of patients. Most late complications were migration and leakage, which occurred in 10.4% and 9.7% of patients respectively. The most common cause for catheter removal was intractable and recurrent peritonitis. The 12- and 24-month survival rates of the catheters were 80.0% and 74.9%. The most significant prognostic factor of percutaneous fluoroscopy-assisted PD catheter survival was late leakage (p < 0.01).

CONCLUSIONS

In addition to the advantages of simplicity, minimal invasiveness, and relative safety, the survival rate of PD catheters placed using the percutaneous fluoroscopy-assisted method was comparable to that of more invasive methods. Percutaneous fluoroscopy-assisted placement of PD catheters should be considered when available, and may be preferred to other placement methods.

摘要

目的

尽管经皮透视可确保腹膜透析(PD)导管放置恰当,但该方法的疗效尚不明确。因此,我们评估了经透视辅助放置PD导管的长期经验。

患者与方法

我们回顾性分析了一所大学附属医院PD中心114例PD患者的134根PD导管。我们评估了与PD导管相关的并发症、导管拔除原因及导管留存情况。我们使用多变量Cox比例风险模型来确定与PD导管留存相关的独立因素。

结果

与置管相关的早期并发症包括1例导管周围出血;无置管失败情况。8.5%的患者出现早期并发症。多数晚期并发症为移位和渗漏,分别发生于10.4%和9.7%的患者。导管拔除的最常见原因是难治性和复发性腹膜炎。导管的12个月和24个月留存率分别为80.0%和74.9%。经皮透视辅助PD导管留存的最显著预后因素是晚期渗漏(p<0.01)。

结论

除操作简单、微创及相对安全等优点外,经皮透视辅助法放置的PD导管留存率与更具侵入性的方法相当。如有条件,应考虑采用经皮透视辅助放置PD导管,且可能优于其他放置方法。

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