Lye W C, Kour N W, van der Straaten J C, Leong S O, Lee E J
Department of Medicine, National University Hospital, Singapore.
Perit Dial Int. 1996;16 Suppl 1:S333-5.
Our objective was to study the impact of peritoneal catheter configuration on continuous ambulatory peritoneal dialysis (CAPD)-related infections, mechanical complications, and patient dropout in a prospective randomized trial. Forty consecutive patients who were commencing CAPD were randomized to receive either a double-cuff, Swan neck coiled catheter or a double-cuff, straight Tenckhoff catheter, implanted by surgical technique. There was no significant difference in the peritonitis rate between the two groups. There was a lower rate of exit-site infection in the Swan neck group compared to the straight catheter group (0.29 vs 0.60 episodes/patient-year, p < 0.05). Catheter-tip migration occurred in 3 patients with the straight catheters compared to one patient with the Swan neck catheter. No patient had to discontinue CAPD because of mechanical complications. The number of CAPD patient dropouts was not significantly different between the two groups. The Swan neck configuration resulted in a significant reduction in the rate of exit-site infections. The coiled component of the catheter may lead to fewer episodes of catheter-tip migration. However, catheter configuration did not influence the number of technique failures.
我们的目标是在一项前瞻性随机试验中研究腹膜导管构型对持续性非卧床腹膜透析（CAPD）相关感染、机械并发症及患者退出治疗的影响。40例开始进行CAPD的连续患者被随机分为两组，分别接受通过外科技术植入的双套囊天鹅颈卷曲导管或双套囊直形Tenckhoff导管。两组间腹膜炎发生率无显著差异。与直形导管组相比，天鹅颈组出口处感染率较低（分别为0.29次/患者-年和0.60次/患者-年，p<0.05）。直形导管组有3例发生导管尖端移位，而天鹅颈导管组有1例。没有患者因机械并发症而不得不停止CAPD治疗。两组间CAPD患者退出治疗的数量无显著差异。天鹅颈构型使出口处感染率显著降低。导管的卷曲部分可能会减少导管尖端移位的发生次数。然而，导管构型并未影响技术失败的数量。
