中国血液净化

中国血液净化 ›› 2014, Vol. 13 ›› Issue (02): 74-76.doi: 10.3969/j.issn.1671-4091.2014.02.003

• 临床研究 • 上一篇    下一篇

腹膜透析置管术中X线辅助导管定位对相关并发症的影响

蔡得汉,罗富里,刘鸿,魏小昌,杨林,钟爱民,李赟   

  1. 江西省人民医院肾内科
  • 收稿日期:2013-08-26 修回日期:2013-12-24 出版日期:2014-02-12 发布日期:2014-02-12
  • 通讯作者: 李赟 Liyun0956@126.com E-mail:caidehan23@sohu.com

The effect of application of X-ray in the positioning of the catheter in peritoneal dialysis catheter implantation to reduce the catheter-related complications

  • Received:2013-08-26 Revised:2013-12-24 Online:2014-02-12 Published:2014-02-12

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摘要： 【摘要】目的 探讨腹透置管术中X线辅助导管定位对减少导管相关并发症的有效性。方法 2009年4月1日－2012年6月30日在江西省人民医院肾内科住院的终末期肾病(慢性肾脏病5期)腹透置管患者124例，随机分为腹透置管组(A组)与X线辅助导管定位组（B组）各62例，A组采用传统开腹腹透置管术，B组步骤同A组，但在收紧荷包前用小C臂机行盆腔X线检查，见导管腹内端位于骨盆底部。比较2组术后腹腔出血、管周渗漏及近远期导管漂移、网膜包裹、腹膜炎等并发症发生率差异。结果 A、B两组患者术后的腹腔出血发生率分别为3.2%、6.5%（P>0.25）；两组均无渗漏；A、B两组1月内导管漂移率分别为6.4%、0,有显著统计学差异（P<0.05），1月内网膜包裹及腹膜炎的发生率两组无明显差异；1年内导管漂移、网膜包裹及腹膜炎的发生率两组无明显差异；患者近远期（1年内）总的并发症发生率A组较B组高，分别为16.1%、11.3%，但两组无显著统计学差异（P>0.25）。结论 腹透置管术中X线辅助导管定位可显著减少近期（1月内）导管漂移的发生，降低近远期腹透置管术总的导管相关并发症，值得临床推广。

关键词: 腹膜透析置管术, 导管定位, 并发症

Abstract: 【Abstract】Objective Placing peritoneal dialysis( PD) catheter in the right place of abdominal cavity was critical for peritoneal dialysis． Our trial was to investigate the effect of application of X-ray in the positioning of the catheter in peritoneal dialysis catheter implantation to reduce the catheter-related complications. Methods From April 1, 2009 to June 30, 2012 ,A total of 124 patients diagnosed as CKD grade 5 were assigned into conventional operation group (group A, n=62 ) and X-ray positioning group(group B, n=62) based on random. group B steps are the same as group A, pursestring suture followed on confirmtion by a small C arm X-ray machine of the distal end of the PD catheter located at the bottom of the pelvis.The differences in early and later complications including bleeding, leakage, catheter displacement , omentum circumvolution and peritonitis were compared between the two groups. Results A, B two groups of patients with bleeding rates are 3.2% and 6.5% respectively (P > 0.25); Two groups have no leakage; A, B two group in 1 month catheter displacement rate were 6.4%, 0, respectively ,there was a significant statistical difference (P < 0.05), omentum circumvolution and the incidence of peritonitis no difference between the two groups within one month; within one year ,catheter displacement, omentum circumvolution, and the incidence of peritonitis were no difference between the two groups; within one year， A, B two groups of patients with the overall incidence of complications are 16.1% and 11.3%, respectively，but there was no statistically significant difference between the two groups (P > 0.25). Conclusion Application of X-ray in the positioning of the catheter in peritoneal dialysis catheter implantation can be significantly reduced early (within one month) catheter displacement, reduced general catheter-related complications in early and later complications, worthy of clinical promotion.

Key words: Peritoneal dialysis catheter implantation, Catheter positioning, Complication