Mellotte G J, Ho C A, Morgan S H, Bending M R, Eisinger A J
South West Thames Regional Renal Unit, St Helier Hospital, Carshalton, Surrey, UK.
Nephrol Dial Transplant. 1993;8(7):626-30.
Percutaneous peritoneal dialysis catheter (PDC) placement is a well-tolerated, rapidly performed side-room procedure that allows the rapid initiation of dialysis without the delay imposed in co-ordinating a surgeon, theatre time, and theatre staff. We retrospectively reviewed the clinical outcome of 230 PDC inserted over a 30-month period. Fifty were placed percutaneously (group P) and 180 were placed using conventional surgical techniques, 107 in patients commencing CAPD (group A) and 73 in patients commencing CAPD (group A) and 73 in patients previously established on CAPD (group B). Total experience accumulated was 2563 patient months: 270 patient months group P, 1381 patient months group A, 912 patient months group B. Percutaneous PDC insertion was non-elective, and reserved for patients unfit for general anaesthesia or haemodialysis. Group P patients were older (P < 0.001) and had increased early mortality (P < 0.005) due to underlying pathology. Death and early mechanical failure contributed to a shorter mean duration of catheter use in group P (9.0 +/- 2.3 months compared to 15.3 +/- 9.6 months group A and 17.3 +/- 9.7 group B) (P < 0.05). The peritonitis rate was similar in group P (1 per 6.75 patient months) and group B (1 per 7.4 patient months) but significantly lower in group A (1 per 15.7 patient months) (P < 0.01). We conclude that percutaneous PDC placement provides a safe, reliable access for peritoneal dialysis and is especially suitable for ill patients who would not tolerate general anaesthesia.
经皮腹膜透析导管（PDC）置入术是一种耐受性良好、操作迅速的床边手术，可迅速开始透析，无需等待协调外科医生、手术时间和手术室工作人员而造成延误。我们回顾性分析了30个月内230例PDC置入术的临床结果。其中50例采用经皮置入（P组），180例采用传统手术技术置入，107例为开始持续性非卧床腹膜透析（CAPD）的患者（A组），73例为之前已接受CAPD治疗的患者（B组）。累积的总经验为2563患者月：P组270患者月，A组1381患者月，B组912患者月。经皮PDC置入为非选择性手术，适用于不适合全身麻醉或血液透析的患者。P组患者年龄较大（P<0.001），由于基础疾病导致早期死亡率增加（P<0.005）。死亡和早期机械故障导致P组导管平均使用时间较短（9.0±2.3个月，而A组为15.3±9.6个月，B组为17.3±9.7个月）（P<0.05）。P组（每6.75患者月1例）和B组（每7.4患者月1例）的腹膜炎发生率相似，但A组显著较低（每15.7患者月1例）（P<0.01）。我们得出结论，经皮PDC置入术为腹膜透析提供了一种安全、可靠的通路，特别适用于无法耐受全身麻醉的患者。
