改良腹膜透析置管术对导管相关并发症的影响

目的 探讨通过改进腹膜透析置管手术方法减少导管相关并发症的发生,提高腹膜透析质量.方法 2014年12月至2015年12月于本院住院的145例终末期肾脏病行腹膜透析置管的患者,随机分为观察组71例和对照组74例进行对照研究,观察并比较两组患者术后1年内漂管移位、网膜包裹、血块或纤维素阻塞、漏液、腹膜炎、隧道炎以及出口感染等并发症的发生率.结果 观察组患者采用改良腹膜透析置管术后1年内导管移位3例(4.22％),网膜包裹2例(2.81％);对照组1年内导管移位10例(13.51％),网膜包裹5例(6.75％),两组比较差异具有统计学意义(P＜0.05).术后随访1年内两组患者总的导管相关并发症发生率,观察组为22.53％(16/71),对照组为40.55％(30/74),具有显著统计学差异(P＜0.05).结论 改良后的腹膜透析置管术可有效降低导管相关并发症,进一步提高腹膜透析的质量,且手术操作简易、方便、安全,利于在基层医院开展运用,具有一定的临床应用价值.

The effect of modified peritoneal dialysis catheter placement on the catheter related complications

Objective To explore the modified peritoneal dialysis catheter placement whether reducing the incidence of catheter related complications,and improving the quality of peritoneal dialysis.Methods From December 2014 to December 2015,145 patients with end-stage renal disease undergoing peritoneal dialysis were admitted in our hospital.They were randomly divided into observation group (71 cases) and control group (74 cases).The catheter related complications 1 year after operation which contained the incidence of catheter migration,omentum enclosing,blood clots or cellulose obstruction,.leakage,peritonitis,and inflammation of the tunnel and exit-site between two groups were compared.Results There were 3 cases (4.22％) with catheter migration,2 cases (2.81％) wrapped in omentum in the observation group with modified peritoneal dialysis catheter,whereas 10 cases (13.51％) with catheter migration,5 cases (6.75％) wrapped in omentum in the control group.There were significant statistical differences between two groups (P ＜ 0.05).During 1 year follow-up,the incidence of total catheter related complications in the observation group and control group was 22.53％ and 40.55％,respectively,with significant statistical differences (P ＜ 0.05).Conclusions The modified peritoneal dialysis operation can effectively reduce catheter-related complications and improve the quality of peritoneal dialysis.It is simple,convenient,and safe in the primary hospitals practice,with certain clinical utility.