Hwang T L, Chen M F, Wu C H, Leu M L, Huang C C
Department of Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College, Taipei, Taiwan, R.O.C.
Eur J Surg. 1995 Jun;161(6):401-4.
To compare four different ways of implanting catheters for continuous ambulatory peritoneal dialysis (CAPD) in an effort to reduce the incidence of complications.
Retrospective study.
Teaching hospital, Taiwan.
166 Patients who had 180 catheters inserted between 1985 and 1993.
49 Catheters were inserted through midline incisions (in 24 of which the catheter was fixed with an additional suture) and 131 were inserted through paramedian incisions (in 88 of which the catheter was fixed with an additional suture).
Morbidity, particularly the incidence of migration of the catheter and incisional hernia.
8/68 Catheters migrated in patients in whom no additional fixing suture had been used, compared with 2/112 in whom an additional suture had been used (p = 0.007). There were 4 incisional hernias in 49 midline, compared with 0/131 paramedian, incisions (p < 0.0001). Significantly more catheters had to be removed after midline than after paramedian incisions (35/49 compared with 56/131, p = 0.0008); chi square for independence 15.02, df 3, p = 0.0018.
For the implantation of catheters for CAPD the paramedian incision is associated with significantly fewer complications than the midline incision and the incidence is even lower if the catheter is fixed to the lower peritoneum with an additional suture.
比较四种不同的持续性非卧床腹膜透析（CAPD）导管植入方法，以降低并发症的发生率。
回顾性研究。
台湾教学医院。
1985年至1993年间植入180根导管的166例患者。
49根导管通过中线切口植入（其中24根导管用额外缝线固定），131根导管通过旁正中切口植入（其中88根导管用额外缝线固定）。
发病率，尤其是导管移位和切口疝的发生率。
未使用额外固定缝线的患者中，68根导管有8根移位，而使用额外缝线的患者中，112根导管有2根移位（p = 0.007）。49例中线切口患者中有4例发生切口疝，而131例旁正中切口患者中无切口疝发生（p < 0.0001）。中线切口后必须拔除的导管明显多于旁正中切口后（49根中有35根，而131根中有56根，p = 0.0008）；独立性卡方检验为15.02，自由度为3，p = 0.0018。
对于CAPD导管植入，旁正中切口的并发症明显少于中线切口，如果用额外缝线将导管固定于下腹膜，则发生率更低。
