腹部手术对腹膜透析的影响

目的 :探讨先前腹部手术对CAPD效能和并发症的影响。方法 :将 81例肾衰竭患者分成两组 :A组4 7例 ,无腹部手术史 ;B组 34例 ,有腹部手术史。随访置管CAPD后第 1、第 7个月腹膜肌酐清除率和生化指标。结果 :两组在开始CAPD后第 1、第 7个月腹膜肌酐清除率均无显著性差异 (P >0 .0 5 ) ,但B组术后血性透出液发生率(17.6 % )高于A组 (2 .1% ) (P <0 .0 5 )。经过半年随访 ,各组内腹膜肌酐清除率保持稳定。随访过程中无疝气、腹壁水肿和胸积液等并发症发生。结论 :既往中小腹部手术一般不影响腹膜透析顺利进行 ,但行腹膜透析置管术时应谨慎 ,术后注意监测腹膜溶质清除能力。

Impact of Previous Abdominal Surgery on Adequacy of Peritoneal Dialysis

Objective:To study the impact of previous abdominal surgery on adequacy and complication of CAPD.Methods:81 ESRD patients were divided into two groups:47 patients without previous surgery in Group A and 34 patients with previous abdominal surgery in Group B.Results:No difference in peritoneal creatinine clearance was found between the two groups both at 1 and 7 months after insertion of peritoneal catheter and initiation of CAPD ( P >0.05).However,the incidence of bloody peritoneal effluent post-operatively was significantly higher in Group B (17.6%) than that in Group A (2.1%) ( P <0.05).The peritoneal creatinine clearance remained stable during follow-up within each group.No complications such as hernia,abdominal wall edema and pleural effluent were found during the follow-up period.Conclusions:Previous minor to moderate abdominal surgery dose not have a major impact on the adequacy of CAPD.However,care should be taken during insertion of peritoneal catheter and monitoring of peritoneal solute clearance is needed.