Arora P, Kohli H S, Kher V, Gupta A, Mishra V, Sharma R K, Kumar P
Department of Nephrology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow.
Indian Pediatr. 1993 Aug;30(8):981-5.
The changing spectrum of acute renal failure (ARF), in children has necessitated the support by peritoneal dialysis (PD) for a longer duration. Use of permanent catheters like Tenckhoff catheter can overcome many of the problems associated with the prolonged use of temporary catheters. Thirty one infants and children with mean (SD) age of 49.3(39.4) months were subjected to PD using surgically placed Tenckhoff catheter. Catheters were put under general anesthesia in 28 patients and under local anesthesia in 3 patients. The technique of catheter insertion has been described in detail. All the catheters, except one, functioned immediately after the insertion. There was no intraperitoneal hemorrhage, dialysate leak or poor catheter drainage. The mean (SD) duration of catheter placement for PD was 11.3 (16.1) days (range 2.90 days). There were 6 episodes of infections (19.2%), peritonitis in 4 (12.8%) and exit site infection in 2 (6.4%). In 2 patients, infection episodes did not respond to antibiotics and the catheter had to be removed. There was no mortality due to complications of PD procedure and catheter insertion. Acute intermittent PD using surgically placed Tenckoff catheter was done safely for prolonged duration and also had additional advantages of good catheter drainage and no intraperitoneal hemorrhage.
儿童急性肾衰竭（ARF）不断变化的疾病谱使得腹膜透析（PD）的支持时间需要延长。使用像Tenckhoff导管这样的永久性导管可以克服许多与长期使用临时导管相关的问题。31例平均（标准差）年龄为49.3（39.4）个月的婴儿和儿童接受了使用手术置入Tenckhoff导管的腹膜透析。28例患者在全身麻醉下置入导管，3例在局部麻醉下置入。导管插入技术已详细描述。除1根导管外，所有导管插入后立即发挥作用。没有发生腹腔内出血、透析液渗漏或导管引流不畅的情况。腹膜透析导管置入的平均（标准差）时间为11.3（16.1）天（范围2.90天）。发生感染6次（19.2%），腹膜炎4次（12.8%），出口处感染2次（6.4%）。2例患者的感染发作对抗生素无反应，不得不拔除导管。没有因腹膜透析操作和导管插入的并发症导致死亡。使用手术置入Tenckhoff导管进行急性间歇性腹膜透析可以安全地进行较长时间，并且还具有导管引流良好和无腹腔内出血的额外优点。
