重症急性肾损伤患者行床边开放式解剖法留置腹膜透析导管的安全性研究

目的:探讨重症急性肾损伤(AKI)患者行床边开放式解剖法留置腹膜透析导管的安全性。方法:广州市第一人民医院2010年1月-2011年12月期间所有行床边开放式解剖法留置腹膜透析导管的重症患进行前瞻性观察,时间为置管后一个月至病人死亡或因各种原因拔除腹膜透析导管,观察置管术后出现的各急性并发症如手术伤口感染、出血、渗液,腹透液引流障碍,腹膜炎等。结果:入组23名患者均为多器官功能竭并AKI,置管术后有发生导管功能不良2例,出现手术伤口脓肿(表面葡萄球菌)、导管出口处感染(表面葡球菌)、同时出现血性腹水和导管出口处出血各1例,无并发腹膜炎。结论:重症AⅪ行床边开放式解剖法留腹膜透析导管安全。

Safety Research of Bedside Open Dissection Tenckhoff Catheter Insertion in Patients with Severe Acute Kidney Injury

Objective： To explore the safety of bedside open dissection Tenckhoff catheter insertion in patients with severe acute kidney injury （AKI）. Methods： Prospective observation was taken for critically ill patients who had bedside open dissection Tenckhoff catheter insertion in from Jan 2010 to Dec 2011. Follow-up period was 1 month after insertion, or censored for death or catheter removal for any reason. The complications after insertion included wound or exit-site infection, hemorrhage, leakage along PD-catheter and peritonitis. Results： 23 cases diagnosed as multiple organ dysfunction failure with AKI were included. There were 2 cases with PD-catheters dysfunction, 1 case with wound abscess （staphylococcus aureus）, 1 case with exit-site infection（staphylococcus aureus）, 1 case with exitsite hemorrhage and hemorrhagic ascites simultaneously. No peritonitis observed. Conclusion： Bedside open dissection Tenckhoff catheter insertion in critically ill patients is safe.