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一种用于插入腹膜透析Tenckhoff导管的简化经皮技术。

A simplified percutaneous technique for inserting Tenckhoff catheters for peritoneal dialysis.

作者信息

Zhao Shiyue, Zhu Xueyan, Li Qi, Zhu Bai, Wang Yangwei, Cui Wenpeng, Zhou Xiaoxi, Lou Yan, Sun Jing, Miao Lining

出版信息

Clin Nephrol. 2019 Jan;91(1):17-24. doi: 10.5414/CN109410.

Abstract

AIM

Successful catheter implantation is highly essential for delivering effective peritoneal dialysis (PD). The aim of the present study was to describe a newly developed, minimally invasive percutaneous technique for providing safe, timely, and effective peritoneal catheter insertion and assess the long-term outcome.

MATERIALS AND METHODS

100 PD catheters were placed in 100 consecutive patients by a nephrologist using the modified percutaneous technique with a special trocar, from August 1, 2010 to December 31, 2011. The patients were followed up until October 31, 2015. Demographic and clinical features of study subjects, duration of hospital stay, follow-up time, complications, and catheter survival were assessed in all patients.

RESULTS

The patient study group included 47 men and 53 women, with a mean age of 55.3 ± 13.7 years. The mean hospitalization time was 17.1 ± 8.6 days, and the mean duration of follow-up was 44.7 ± 15.1 months. 71 patients were still on continuous ambulatory peritoneal dialysis at the time of study completion. Peritonitis was the most common complication observed, with an incidence of 28%. None of the patients experienced surgical complications such as bleeding or incisional hernia. The mean catheter survival time was 57.0 ± 1.5 months.

CONCLUSION: Peritoneal catheter placement using our modified percutaneous technique is simple, safe, minimally invasive, and efficient. It carried less morbidity with respect to bowel perforation, catheter-related infection, and exit-site leak.
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摘要

目的

成功植入导管对于进行有效的腹膜透析(PD)至关重要。本研究的目的是描述一种新开发的微创经皮技术,用于安全、及时且有效地插入腹膜导管,并评估其长期效果。

材料与方法

2010年8月1日至2011年12月31日,一名肾病科医生使用改良的经皮技术及特殊套管针为100例连续患者置入了100根腹膜导管。对患者进行随访直至2015年10月31日。评估了所有患者的人口统计学和临床特征、住院时间、随访时间、并发症及导管存活情况。

结果

患者研究组包括47名男性和53名女性,平均年龄为55.3±13.7岁。平均住院时间为17.1±8.6天,平均随访时间为44.7±15.1个月。研究结束时,71例患者仍在进行持续非卧床腹膜透析。腹膜炎是观察到的最常见并发症,发生率为28%。没有患者发生出血或切口疝等手术并发症。导管平均存活时间为57.0±1.5个月。

结论

使用我们改良的经皮技术置入腹膜导管简单、安全、微创且高效。在肠穿孔、导管相关感染和出口处渗漏方面发病率较低。

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