应用流程处理腹膜透析导管引流不畅

[目的]分析腹膜透析病人导管引流不畅的原因,探讨有效的预防和护理方法。[方法]采用追踪性研究方法．2007年11月-2008年3月在本科行腹膜透析置管术的病人120例,观察开始时间为病人腹膜透析置管术后当天,观察总时间为5个月。分析腹膜透析病人导管引流不畅的原因,制订腹膜透析导管引流不畅的预防和护理流程。对腹膜透析置管术后病人进行教育后,观察病人出现导管引流不畅的时间、运用流程处理后的效果。[结果]120例腹膜透析病人中,发生导管引流不畅13例．发生时间为术后3d～117d。引流不畅原因为导管移位8例,腹胀、便秘4例,大网膜包裹1例。运用流程进行处理后9例病人透析管11流恢复正常,4例病人重新手术后亦恢复了正常的透析。[结论]术后早期教育可预防腹膜透析导管引流不畅的发生,如导管发生引流不畅．早期发现并及时应用流程处理可减少重新手术的可能。     

用国产碘伏液作腹透消毒液的研究

为了减轻持续性不卧床腹膜透析(CAPD)的经济负担,特别是使用O型管组患者,我们试用价廉的国产碘伏液作O型管组消毒液,代替现时用的昂贵的进口的amukin消毒液。 方法 54名我院用O型管组作CAPD患者,随机分为二组,28例用amukin消毒液(0.5％次氯酸钠),26例用国产的0.5％碘伏(聚维酮碘,povidon iodine),观察其使用后的腹膜炎发生率,并将O型管分别浸干两     

透出液蛋白丢失与连续性非卧床腹膜透析患者营养不良-炎性反应-动脉硬化综合征的相关性

Objective To investigate the impact of peritoneal albumin leakage on malnutrition-inflammation-atherosclerosis (MIA) syndrome in continuous ambulatory peritoneal dialysis (CAPD) patients. Methods A cross-sectional study of a cohort of 130 CAPD patients without edema or active infection was performed. In order to identify peritoneal transport characteristics in CAPD patients, a standard peritoneal equilibration test (PET) was carried out. For malnutrition and inflammation, serum albumin and high-sensitivity C-reactive protein (hs-CRP) levels were measured. Mean-carotid artery intima media thickness (IMT) was used to determine atherosclerosis. Residual glomerular filtration rate (rGFR) was defined as the average of 24-hour urinary urea and creatinine clearances. Results Pearson and Spearman correlation analysis showed that peritoneal albumin leakage amount was positively correlated with age, body mass index, night dwell time, blood glucose, 4 h D/P creatinine levels and hs-CRP levels (r=0.204, P<0.05 ;r=0.314, P<0.01; r=0.265, P<0.01; r=0.212, P<0.05; r=0.401, P<0.01; r=0.216, P<0.05); whereas it was negatively correlated with diastolic perssure, serum albumin levels, glucose level of dialyzate and peritoneal Kt/V (r=-0.209, P<0.05; r=-0.123, P<0.05; r=-0.271, P<0.01; r=-0.212, P<0.01). Overall, there was no correlation between peritoneal albumin leakage and IMT. Patients was significantly greater (P<0.01), and there was a positive correlation between peritoneal albumin leakage amount and IMT (r=0.650, P<0.01). Conclusions Peritoneal albumin leakage is significantly associated with peritoneal transport characteristics, malnutrition and inflammatory state in CAPD patients. High peritoneal albumin leakage amount is a risk factor for atherosclerosis in patients with rGFR less than 1 ml·min-1(1.73 m2)-1.