Cheng I K, Chan C Y, Cheng S W, Poon J F, Ji Y L, Lo W K, Chan D T
Department of Medicine, University of Hong Kong.
Perit Dial Int. 1994;14(3):255-60.
To compare the clinical outcome and cost-effectiveness of three techniques for continuous ambulatory peritoneal dialysis (CAPD): the conventional spike technique (C), the O-set (O), and UVXD (U, ultraviolet irradiation connection box).
A randomized and prospective comparison of three CAPD techniques.
A tertiary referral and a satellite dialysis center.
One hundred patients with end-stage renal failure between 10 and 70 years of age, with good hand-eye coordination and not anticipated to receive a living related transplant within 6 months.
Patients were randomized by referral to a table of random numbers to perform one of the three CAPD techniques.
Training time, details of peritonitis and exit-site infection (ESI) including the costs of antibiotic treatment, outpatient visits, hospital stays, technique, and patient survival were analyzed after a minimum follow-up period of one year.
There were 38, 31, and 31 patients in groups C, O, and U, respectively, and the total observation periods were 838, 802, and 745 patient-months, respectively. The peritonitis rates for C, O, and U were 21.5, 30.8, and 29.8 patient-months/episode, respectively. The corresponding ESI rates were 16.4, 14.9, and 24 patient-months/episode, respectively. When the time from the commencement of CAPD to the first infection was expressed using the Kaplan-Meier life table analysis, 39.5%, 67.7%, and 61.3% of patients in Groups C, O, and U were free from peritonitis at one year (p = 0.088). The corresponding figures for ESI were 52.6%, 48.4%, and 61.3% (p = 0.35). There was no significant difference in technique survival in the three treatment groups. An analysis of the costs related to the use of antibiotics, outpatient visits, and hospital stays necessary for the treatment of peritonitis and ESI and those related to training time, additional equipment, and consumables required for the three CAPD techniques showed that, overall, the cost in O was the lowest, followed by U and C (U.S. $158, $170, and $179 per patient-month, respectively).
It was concluded that the O-set is a more cost-effective CAPD technique than UVXD, while both are more cost-effective than the conventional spike technique.
比较持续性非卧床腹膜透析（CAPD）的三种技术：传统穿刺技术（C）、O型装置（O）和UVXD（U，紫外线照射连接盒）的临床结局和成本效益。
三种CAPD技术的随机前瞻性比较。
一家三级转诊中心和一家卫星透析中心。
100例年龄在10至70岁之间的终末期肾衰竭患者，手眼协调性良好，预计6个月内不会接受亲属活体移植。
根据随机数字表将患者随机分组，以进行三种CAPD技术之一。
在至少一年的随访期后，分析培训时间、腹膜炎和出口处感染（ESI）的详细情况，包括抗生素治疗费用、门诊就诊、住院、技术和患者生存率。
C组、O组和U组分别有38例、31例和31例患者，总观察期分别为838、802和745患者月。C组、O组和U组的腹膜炎发生率分别为21.5、30.8和29.8患者月/次。相应的ESI发生率分别为16.4、14.9和24患者月/次。当使用Kaplan-Meier生存表分析从CAPD开始到首次感染的时间时，C组、O组和U组分别有39.5%、67.7%和61.3%的患者在一年时无腹膜炎发生（p = 0.088）。ESI的相应数字分别为52.6%、48.4%和61.3%（p = 0.35）。三个治疗组的技术生存率无显著差异。对治疗腹膜炎和ESI所需的抗生素使用、门诊就诊和住院费用以及三种CAPD技术所需的培训时间、额外设备和耗材相关费用的分析表明，总体而言，O组的成本最低，其次是U组和C组（分别为每位患者每月158美元、170美元和179美元）。
得出结论，O型装置是一种比UVXD更具成本效益的CAPD技术，而两者都比传统穿刺技术更具成本效益。
