Roldaan B A, Bosch F H, Eggink W F, van Leusen R
Afd. Algemene Chirurgie, Ziekenhuis Rijnstate, Arnhem.
Ned Tijdschr Geneeskd. 1993 Jul 10;137(28):1392-6.
To determine the number of surgical complications in patients treated with continuous ambulatory peritoneal dialysis (CAPD).
Retrospective (1980-1989), partially prospective (1987-1989).
Rijnstate Hospital, Arnhem, the Netherlands.
In 1978 CAPD was introduced in the Netherlands. Since 1980 we have used this technique in our clinic. Over the period 1980-1989 we studied the number of surgical complications of CAPD and the loss of catheter caused by these complications. With these numbers the probability of having a functioning Tenckhoff double cuff catheter was calculated with the Kaplan-Meier method.
101 patients (54 men (mean age 52.5 years), 47 women (mean age 49.6 years)) with terminal renal insufficiency were treated during the study period. 123 catheters were implanted of which 33 had to be removed afterwards. The probability of having a functioning catheter after one year was 85%, after two years 64% and after three years 53%. Peritonitis was the main cause of temporary or final loss of the catheter. The number of observed cases of peritonitis was 187.
Methods to improve the survival of the catheter are prevention of peritonitis by using an appropriate system for the fluid exchanges, screening patients for the existence of diverticulosis before starting CAPD, and prevention of exit site and tunnel infections.
确定接受持续性非卧床腹膜透析（CAPD）治疗患者的手术并发症数量。
回顾性研究（1980 - 1989年），部分前瞻性研究（1987 - 1989年）。
荷兰阿纳姆的莱茵斯泰特医院。
1978年荷兰引入CAPD。自1980年起我们在诊所使用该技术。在1980 - 1989年期间，我们研究了CAPD的手术并发症数量以及由这些并发症导致的导管丢失情况。利用这些数据，采用Kaplan - Meier方法计算Tenckhoff双套囊导管保持功能的概率。
研究期间，101例（54例男性（平均年龄52.5岁），47例女性（平均年龄49.6岁））终末期肾功能不全患者接受了治疗。共植入123根导管，其中33根后来不得不拔除。一年后导管保持功能的概率为85%，两年后为64%，三年后为53%。腹膜炎是导管暂时或最终丢失的主要原因。观察到的腹膜炎病例数为187例。
提高导管存活率的方法包括通过使用合适的液体交换系统预防腹膜炎、在开始CAPD前筛查患者是否存在憩室病以及预防出口处和隧道感染。
