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采用牵拉技术拔除腹膜透析导管的有效性和安全性

Efficacy and safety of removing peritoneal dialysis catheters using the pull technique.

作者信息

Zhang Lina, Ma Xu, Zheng Yanping, Tian Suge, Zhang Jing, Yan Lei, Gu Yue, Shao Fengmin

机构信息

Henan Provincial Key Laboratory of Kidney Disease and Immunology, Department of Nephrology, Peritoneal Dialysis Center, Henan Provincial Clinical Research Center for Kidney Disease, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China.

出版信息

Int Urol Nephrol. 2024 Mar;56(3):1129-1135. doi: 10.1007/s11255-023-03761-4. Epub 2023 Aug 30.

Abstract

PURPOSE

To study the efficacy and safety of peritoneal dialysis (PD) catheter removal using the pull technique.

METHODS

We conducted a retrospective analysis of 36 patients in whom the pull technique was used to remove a PD catheter. We evaluated the efficacy, safety, and health economic benefits of this technique by analyzing the pain score, duration of the procedure, complications during or after the procedure, and cost.

RESULTS

The mean age (± standard deviation) of the 36 patients was 51 ± 14 years involving 27 males and 9 females with a mean body mass index was 23.4 ± 2.6. The mean duration of PD was 28 months (range 4-96 months). The site of the pull technique for peritoneal dialysis catheter removal was at the bedside or in the treatment room, with local anesthesia or no anesthesia. The mean duration of the procedure (from anesthesia to complete removal of the PD catheter) was 5-15 min. Only one patient experienced catheter rupture and no patients developed procedural or post-procedural bleeding or abdominal wall leakage. Infection did not occur at the inner or outer cuffs, tunnel, or outlet. Pain scores analyzed by a 10-point visual analogue scoring technique both immediately and 24 h after the procedure were 3.5 ± 1.7 and 1.2 ± 0.8, respectively.

CONCLUSIONS

The pull technique is simple to perform, takes a short time, results in few complications and small wounds, causes only mild pain, enables fast recovery, and results in low medical costs.

摘要

目的

研究采用牵拉技术拔除腹膜透析(PD)导管的有效性和安全性。

方法

我们对36例采用牵拉技术拔除PD导管的患者进行了回顾性分析。通过分析疼痛评分、操作持续时间、操作期间或之后的并发症以及费用,来评估该技术的有效性、安全性和健康经济效益。

结果

36例患者的平均年龄(±标准差)为51±14岁,其中男性27例,女性9例,平均体重指数为23.4±2.6。PD的平均持续时间为28个月(范围4 - 96个月)。采用牵拉技术拔除腹膜透析导管的操作地点在床边或治疗室,采用局部麻醉或不麻醉。操作的平均持续时间(从麻醉到完全拔除PD导管)为5 - 15分钟。仅1例患者发生导管破裂,无患者出现操作期间或操作后出血或腹壁渗漏。内袖口、外袖口、隧道或出口均未发生感染。采用10分视觉模拟评分技术分析,操作后即刻和24小时的疼痛评分分别为3.5±1.7和1.2±0.8。

结论

牵拉技术操作简单、耗时短、并发症少、伤口小、仅引起轻度疼痛、恢复快且医疗成本低。

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