Abdel Aal Ahmed Kamel, Mahmoud Khalid, Moustafa Amr Soliman, Aboueldahab Noha Alaaeldin, Souid Anas, Gunn Andrew, Li Yufeng, Wang Zhixin, Almehmi Ammar
Department of Diagnostic and Interventional Imaging, University of Texas Health Science Center at Houston, Houston, TX 77030, USA.
Department of Radiology, University of Alabama at Birmingham, Birmingham, AL 35233, USA.
Radiol Res Pract. 2020 Apr 25;2020:3751827. doi: 10.1155/2020/3751827. eCollection 2020.
The aim of this study is to compare the outcomes of the elective-start versus urgent-start use of peritoneal dialysis (PD) catheters using percutaneous radiologic or laparoscopic techniques. Patients having their first peritoneal dialysis catheter placed and used between January 2005 and January 2018 were identified, and their medical records were retrospectively reviewed. Two groups were identified: elective-start ( = 211) and urgent-start ( = 29). Patient's demographics were similar between the two groups with the exception of age, which was higher in the elective-start group. The catheter complication rates and catheter removal rates at 3 and 12 months, mean days-to-first complication, mean days-to-catheter removal, and overall patient survival at 12 months were analyzed. Catheter complication rates at 3 and 12 months were similar between the two groups (27.8% and 48.9%, respectively, in the elective-start group versus 35.9% and 54.2%, respectively, in the urgent-start group, =0.415). The catheter removal rates at 3 and 12 months were also similar between the two groups (=0.088). Catheter leak was higher in the urgent-start group (13.8% versus 3.3%, respectively, =0.011). There was no difference between the elective-start and the urgent-start groups in the mean days-to-first complication (95 vs 69, =0.086), mean days-to-catheter removal (145 vs 127, =0.757), and overall patient survival at 12 months (100% vs 97%, =0.41). In conclusion, apart from catheter leak, there were similar rates of catheter complication and removal for PD catheter used for the elective-start compared to the urgent-start PD. Furthermore, the technique of placement did not affect the outcomes.
本研究旨在比较采用经皮放射学或腹腔镜技术择期开始与紧急开始使用腹膜透析（PD）导管的效果。确定了2005年1月至2018年1月期间首次置入并使用腹膜透析导管的患者，并对其病历进行回顾性分析。确定了两组：择期开始组（n = 211）和紧急开始组（n = 29）。除年龄外，两组患者的人口统计学特征相似，择期开始组的年龄较高。分析了3个月和12个月时的导管并发症发生率、导管拔除率、首次并发症的平均天数、导管拔除的平均天数以及12个月时的总体患者生存率。两组在3个月和12个月时的导管并发症发生率相似（择期开始组分别为27.8%和48.9%，紧急开始组分别为35.9%和54.2%，P = 0.415）。两组在3个月和12个月时的导管拔除率也相似（P = 0.088）。紧急开始组的导管渗漏率较高（分别为13.8%和3.3%，P = 0.011）。择期开始组和紧急开始组在首次并发症的平均天数（95天对69天，P = 0.086）、导管拔除的平均天数（145天对127天，P = 0.757）以及12个月时的总体患者生存率（100%对97%，P = 0.41）方面没有差异。总之，除导管渗漏外，与紧急开始腹膜透析相比，择期开始使用腹膜透析导管的导管并发症和拔除率相似。此外，置管技术不影响治疗效果。
