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一种简单改良的经腹腹膜透析置管术可减少二次手术的需求。

A simple modified open peritoneal dialysis catheter insertion procedure reduces the need for secondary surgery.

机构信息

Radiology Department, The Fifth Affiliated Hospital of Sun Yat-sen University, No. 52 Meihua Road, Zhuhai, 519000, China.

Nephrology Department, The Fifth Affiliated Hospital of Sun Yat-sen University, No. 52 Meihua Road, Zhuhai, 519000, China.

出版信息

Int Urol Nephrol. 2019 Apr;51(4):729-736. doi: 10.1007/s11255-019-02101-9. Epub 2019 Mar 4.

Abstract

BACKGROUND

The aim of this retrospective study was to assess the efficacy of a modified peritoneal dialysis catheter insertion technique for reducing the incidence of mechanical complications.

METHODS

We conducted a retrospective analysis of clinical data of 346 patients undergoing peritoneal dialysis catheter insertion at our peritoneal dialysis center. The traditional procedure was performed in 157 patients (group A) and the modified procedure in 189 patients (group B). The double-polyester-cuff straight Tenckhoff catheter was used in all patients.

RESULTS

At the end of 1 year, tunnel inflammation was more common in group A (21 patients after 0.011 patient-months follow-up versus 10 patients in group B after 0.007 patient-months of follow-up; p = 0.009). Technical survival rate of the catheter was significantly higher in group B (97.35% in group B vs. 89.81% in group A; p = 0.005). All-cause mortality was not significantly different between the two groups (4.5% in group A vs. 3.2% in group B; p = 0.532). Postoperative mechanical complications were also higher in group A (32 patients [20.4%] in group A vs. 3 patients [1.6%] in group B; p < 0.001). The incidences of complications such as hernia, dialysis fluid leakage, hemorrhage, incision infection, and prolapse of the polyester cuff were similar in the two groups.

CONCLUSION

The simple modified peritoneal dialysis catheter insertion procedure decreases the occurrence of catheter migration andomental encapsulation and improves the technical survival rate of the catheter.

摘要

背景

本回顾性研究旨在评估改良腹膜透析置管技术减少机械并发症发生率的疗效。

方法

我们对我院腹膜透析中心 346 例行腹膜透析置管术患者的临床资料进行回顾性分析。157 例患者采用传统方法(A 组),189 例患者采用改良方法(B 组)。所有患者均使用双涤纶套直管 Tenckhoff 导管。

结果

1 年后,隧道炎在 A 组更常见(A 组有 21 例,0.011 患者月随访,B 组有 10 例,0.007 患者月随访;p=0.009)。B 组导管技术生存率显著较高(B 组 97.35%,A 组 89.81%;p=0.005)。两组全因死亡率无显著差异(A 组 4.5%,B 组 3.2%;p=0.532)。A 组术后机械并发症也更高(A 组 32 例[20.4%],B 组 3 例[1.6%];p<0.001)。两组疝、透析液渗漏、出血、切口感染和涤纶套脱垂等并发症的发生率相似。

结论

改良腹膜透析置管术操作简单,可减少导管迁移和网膜包裹的发生,提高导管技术生存率。

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