腹膜透析患者术后下床时间对置管效果的影响

目的探讨腹膜透析(peritoneal dialysis,PD)患者术后下床时间对置管效果的影响。方法便利抽样法选取2010年1月至2011年11月在南京军区南京总院解放军肾脏病研究所行PD置管的312例终末期肾功能衰竭患者为研究对象,按PD置管术日的单双号将其分为两组,置管日期为单号的患者为观察组(共156例),术后4h后下床活动;置管日期为双号的患者为对照组(共156例),采用常规的护理模式,即术后24h下床活动。比较两组患者术后窦道情况、窦道出口处情况及导管移位的发生情况。结果两组患者窦道均顺利形成,无红肿、压痛,未出现分泌物,其窦道出口处均未见出血或漏液。观察组患者导管移位率低于对照组,差异有统计学意义(χ2=5.606,P=0.018)。结论安全有效的早期术后活动,有利于降低患者术后的导管移位率,提高腹透患者的早期护理质量。

Effects of Postoperative Off-bed Time on Peritoneal Dialysis Patients after Catheter Intubation

Objective To investigate the effects of off-bed time on peritoneal dialysis（PD） patients after catheter intubation. Methods From January 2010 to November 2011,312 end-stage renal failure patients undergoing PD in the hospital were selected using convenience sampling method. A total of 156 patients receiving catheter displacements on single day were selected as observational group to get out of bed 4 hours after catheter displacement. Then 156 patients on double day were selected as control group to undergo conventional nursing mode and get out of bed after 24 postoperative hours. Comparisons were conducted on the situation of postoperative sinus and sinus exit and the rate of catheter displacement of the two groups. Results The sinus were successfully formed in the two groups, with no swelling, tenderness and the discharge. No bleeding or leakage occurred at the exit of the sinus. The rate of catheter displacement in the observational group was significantly lower than that of the control group （X2= 5. 606,P=0. 018 ）. Conclusion The safer and earlier postoperative activity is beneficial in reducing the postoperative catheter displacement rate and improving the nursing quality of PD patients.