Leaños-Miranda A, Garduño-Espinosa J, Martínez-García M C
Hospital General de Zona No. 1-A Los Venados, Instituto Mexicano del Seguro Social, México, D.F.
Rev Invest Clin. 1997 May-Jun;49(3):189-95.
To determine the frequency, time of occurrence and factors associated with the failure of the permanent peritoneal catheter during dialysis in cases of chronic renal failure (CRF).
A retrospective cohort under a nested case control design was studied at a second level health care unit of the Instituto Mexicano del Seguro Social. A total of 149 catheters, double cushion straight Tenckhoff type, were evaluated in 74 patients with CRF due to diabetic nephropathy in 36/74 patients (49%). Information concerning functionality time and causes of catheter failure as well as the clinical and technical factors concerning insertion were obtained from the clinical chart.
The cumulated time of dialysis was 814 months. Catheter failure occurred in 101 cases (68%): 67 due to obstruction, 24 due to infection, to leakage in 6 and to other causes in 4. Those of non-infectious origin were more frequent (p < 0.01). In the first month post-insertion there was a higher number of failures than after one month, (p < 0.0005). The global functionality of the catheter at one month, one and two years was 55%, 31% and 16%, respectively. There was a greater permanence of the catheters in continuous ambulatory peritoneal dialysis than in intermittent peritoneal dialysis (p = 0.02).
It is concluded that the frequency of the peritoneal catheter failure was high; that the most frequent cause was due to non-infectious complications during the first month of insertion; and the factor associated to catheter failure was intermittent peritoneal dialysis as compared to continuous ambulatory dialysis.
确定慢性肾衰竭(CRF)患者透析期间永久性腹膜导管失败的频率、发生时间及相关因素。
在墨西哥社会保障局的二级医疗保健单位进行了一项嵌套病例对照设计的回顾性队列研究。对74例因糖尿病肾病导致CRF的患者中的149根双缓冲直管Tenckhoff型导管进行了评估,其中36/74例患者(49%)使用了该导管。从临床病历中获取了有关导管功能时间、失败原因以及插入相关的临床和技术因素的信息。
透析累计时间为814个月。导管失败发生在101例(68%):67例因阻塞,24例因感染,6例因渗漏,4例因其他原因。非感染性原因导致的失败更为常见(p < 0.01)。插入后第一个月的失败数量高于一个月后(p < 0.0005)。导管在1个月、1年和2年时的总体功能分别为55%、31%和16%。持续性非卧床腹膜透析中导管的留存时间比间歇性腹膜透析更长(p = 0.02)。
得出结论,腹膜导管失败的频率较高;最常见的原因是插入后第一个月的非感染性并发症;与导管失败相关的因素是与持续性非卧床透析相比的间歇性腹膜透析。