Gallieni Maurizio, Giordano Antonino, Pinerolo Cristina, Cariati Maurizio
2 Department of Clinical and Biomedical Sciences "Luigi Sacco", University of Milan, Milan - Italy.
J Vasc Access. 2015;16 Suppl 9:S68-72. doi: 10.5301/jva.5000369. Epub 2015 Mar 8.
In peritoneal dialysis (PD), a well-functioning catheter is of great importance, because a dysfunctional catheter may be associated with incidence of peritonitis, efficiency of dialysis, and to the overall quality of treatment, representing one of the main barriers to optimal use of PD. When considering the relationship between PD catheter type and outcomes, we should keep in mind the different types of available PD catheters, those that are most commonly used in clinical practice, and the available head-to-head comparisons in the literature. The main differences in PD catheter design include the number of cuffs, the shape of subcutaneous tract (straight vs. swan neck), and the shape of intraperitoneal tract (straight vs. coiled). The availability of the best catheter design and materials, along with a skillful management of PD access, may have the greatest impact on long-term patient outcome on PD. It is now established that the use of straight catheters may improve outcomes and technique survival, but further advances in PD catheter technology can potentially improve technique survival. The self-locating PD catheter is a well established device that has not been fully studied and it may represent, based on the available observational evidence and on the clinical experience, an already existing technological advance deserving further studies.
在腹膜透析（PD）中，功能良好的导管至关重要，因为功能失调的导管可能与腹膜炎的发生率、透析效率以及整体治疗质量相关，是优化使用PD的主要障碍之一。在考虑PD导管类型与治疗结果之间的关系时，我们应牢记现有的不同类型的PD导管、临床实践中最常用的导管类型以及文献中现有的直接比较。PD导管设计的主要差异包括袖套数量、皮下通道形状（直形与鹅颈形）以及腹腔内通道形状（直形与盘绕形）。最佳导管设计和材料的可用性，以及对PD通路的熟练管理，可能对PD患者的长期治疗结果产生最大影响。现已证实，使用直形导管可能改善治疗结果和技术生存率，但PD导管技术的进一步发展可能会潜在地提高技术生存率。自定位PD导管是一种已确立的装置，但尚未得到充分研究，基于现有的观察证据和临床经验，它可能代表一项值得进一步研究的现有技术进步。
