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经泌尿科医师施行隧道外露处理中的腹膜透析导管挽救术。

Peritoneal dialysis catheter salvage performed by nephrologists in tunnel exposure management.

机构信息

Division of Nephrology, Department of Internal Medicine, College of Medicine, Yeungnam University, 170 Hyeonchung-ro, Nam-gu, Daegu, 42415, Republic of Korea.

出版信息

BMC Nephrol. 2022 May 5;23(1):171. doi: 10.1186/s12882-022-02804-9.

Abstract

BACKGROUND

Tunnel exposure, a non-infectious complication, is a rare finding in peritoneal dialysis (PD) patients, which has been described in some case reports. Our study aimed to present catheter salvage therapy using a revision procedure of tunnel exposure by nephrologists.

METHODS

Our retrospective study was conducted between July 1998 and October 2021. We identified all PD patients with tunnel exposure from a database of a tertiary medical center. Tunnel exposure was diagnosed following gross inspection by clinicians during outpatient consultations. We attempted revision with partial external cuff shaving and creating a new tunnel without catheter change.

RESULTS

Fourteen cases in 12 patients were diagnosed as tunnel exposure. The median age at presentation of tunnel exposure was 51 years. Eleven patients underwent revision, and the PD catheter was removed in one patient. The patients who underwent revision were followed up for 6 months. The catheter salvage rate was 72.7%.

CONCLUSIONS

The present study demonstrated that catheter revision performed by nephrologists could be a valuable alternative for original catheter salvage before considering catheter removal in tunnel exposure management.

摘要

背景

隧道外露是一种非感染性并发症,在腹膜透析(PD)患者中较为罕见,已有个案报道。本研究旨在介绍肾脏病医生采用隧道外露修正术来进行导管修复治疗。

方法

本回顾性研究于 1998 年 7 月至 2021 年 10 月进行。我们从一家三级医疗中心的数据库中确定了所有患有隧道外露的 PD 患者。临床医生在门诊就诊时通过肉眼观察诊断隧道外露。我们尝试了部分外袖套刮除和重新建立新隧道而不更换导管的修正术。

结果

12 名患者中的 14 例被诊断为隧道外露。隧道外露的中位发病年龄为 51 岁。11 名患者接受了修正术,1 名患者的 PD 导管被取出。接受修正术的患者随访 6 个月,导管保留率为 72.7%。

结论

本研究表明,在考虑隧道外露处理中导管移除之前,肾脏病医生进行的导管修正术可能是一种有价值的替代原始导管保留的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/085a/9069734/5fe83b6243f8/12882_2022_2804_Fig1_HTML.jpg

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