Gong Lifeng, Xu Wei, Tang Weigang, Lu Jingkui, Li Yani, Jiang Huaqin, Li Hui
Department of Nephrology, Wujin Hospital Affiliated with Jiangsu University.
Department of Nephrology, The Wujin Clinical College of Xuzhou Medical University, Changzhou City, Jiangsu Province, China.
Medicine (Baltimore). 2020 Nov 25;99(48):e23311. doi: 10.1097/MD.0000000000023311.
The objective of this study was to compare the complications of low-site peritoneal dialysis (PD) catheter placement and traditional open surgery in peritoneal dialysis catheter insertion.
The following databases were searched from inception to September 6, 2019: PubMed, Embase, the Cochrane Library, China National Knowledge Infrastructure, and Wanfang. Eligible studies comparing low-site PD catheter placement and traditional open surgery in peritoneal dialysis catheter insertion were included. The data were analyzed using Review Manager Version 5.3.
Seven studies were included in the meta-analysis. A total of 504 patients were included in the low-site PD catheter placement group, and 325 patients were included in the traditional open surgery group. Compared with traditional open surgery, low-site PD catheter placement had a lower incidence rate of catheter displacement (odds ratios [OR] 0.11, 95% CI 0.05-0.22, P < .01) and noncatheter displacement dysfunction (OR 0.11, 95% CI 0.04-0.31, P < .01). However, there was no difference between the 2 catheter insertion methods concerning bleeding (OR 0.53, 95% CI 0.23-1.22, P = .13), PD fluid leakage (OR 0.40, 95% CI 0.15-1.10, P = .07), hypogastralgia (OR 0.95, 95% CI 0.32-2.80, P = .93), peritonitis (OR 0.70, 95% CI 0.32-1.54, P = .38), or exit-site and tunnel infections (OR 0.39, 95% CI 0.14-1.03, P = .06).
Low-site PD catheter placement reduced the risk of catheter displacement and noncatheter displacement dysfunction and did not increase the risk of bleeding, PD fluid leakage, hypogastralgia, peritonitis, or exit site and tunnel infections. Additional large multicenter randomized controlled trials are needed to confirm these conclusions.
本研究的目的是比较低位腹膜透析（PD）导管置入术与传统开放手术在腹膜透析导管插入术中的并发症。
检索了从开始到2019年9月6日的以下数据库：PubMed、Embase、Cochrane图书馆、中国知网和万方。纳入比较低位PD导管置入术与传统开放手术在腹膜透析导管插入术中的合格研究。使用Review Manager 5.3版对数据进行分析。
7项研究纳入荟萃分析。低位PD导管置入术组共纳入504例患者，传统开放手术组纳入325例患者。与传统开放手术相比，低位PD导管置入术的导管移位发生率较低（比值比[OR]0.11，95%可信区间[CI]0.05-0.22，P<0.01）和非导管移位功能障碍发生率较低（OR 0.11，95%CI 0.04-0.31，P<0.01）。然而，两种导管插入方法在出血（OR 0.53，95%CI 0.23-1.22，P=0.13）、腹膜透析液渗漏（OR 0.40，95%CI 0.15-1.10，P=0.07）、下腹痛（OR 0.95，95%CI 0.32-2.80，P=0.93）、腹膜炎（OR 0.70，95%CI 0.32-1.54，P=0.38）或出口处和隧道感染（OR 0.39，95%CI 0.14-1.03，P=0.06）方面无差异。
低位PD导管置入术降低了导管移位和非导管移位功能障碍的风险，且未增加出血、腹膜透析液渗漏、下腹痛、腹膜炎或出口处和隧道感染的风险。需要更多大型多中心随机对照试验来证实这些结论。
