中国血液净化

›› 2008, Vol. 7 ›› Issue (10): 552-554.

• 论著 • 上一篇    下一篇

不同类型腹膜透析导管临床应用体会

周 岩 俞雨生 王金泉 唐 政 季大玺 黎磊石   

  1. 210002 南京，南京军区南京总医院 解放军肾脏病研究所
  • 收稿日期:2008-05-21 修回日期:1900-01-01 出版日期:2008-10-08 发布日期:2008-10-08

Clinical experiences in peritoneal dialysis using different types of catheters

ZHOU Yan, YU Yu-sheng, WANG Jin-quan, TANG Zheng, JI Da-xi, LI Lei-shi.
  

  1. Research Institute of Nephrology, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China
  • Received:2008-05-21 Revised:1900-01-01 Online:2008-10-08 Published:2008-10-08

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摘要： 目的 观察不同类型腹膜透析导管的近期并发症的发生率情况及防治体会。 方法 68例终末期肾衰行维持性腹膜透析治疗患者分为两组。组1：28例患者采用Tenckhoff曲管；组2：40例患者采用鹅颈直管。两组患者随访时间均大于6个月。观察两组患者的腹膜透析液引流速度、隧道感染、出口感染、导管移位、腹膜透析液渗漏等发生情况。结果 两组患者腹膜透析液引流速度的隧道感染率和出口感染率无差别(P＞0.05).Tenckhoff管组5例患者出现导管移位(17.8%)，而swan-neck导管组仅2例(5%)，两组相比有显著性差异(P＜0.05)。进一步分析发现前组患者漂管发生于第一周3例(60%)，第二周2例(40%)，而鹅颈直管发生漂管多于1周内。另外鹅颈直管组有3例患者于术后第一周出现引流不畅，拔管时发现导管内均有大量蛋白凝块阻塞。结论 不同类型导管各有优缺点，鹅颈直管的导管移位率明显低于Tenckhoff导管，但易发生透析液引流不畅，而Tenckhoff导管不容易发生堵管。在置管过程中调整swan-neck腹膜透析管外段与腹正中线的角度后能明显改观引流速度。

关键词: 腹膜透析, 置管术, Tenckhoff曲管, 鹅颈直管

Abstract:

Objective To investigate the clinical indication and complication of peritoneal dialysis using different types of dialysis catheters. Methodology Sixty-eight patients with end stage renal disease on peritoneal dialysis were divided into two groups. Twenty-eight patients used Tenckhoff-coil catheter were assigned in group 1, and 40 patients used swan-neck straight type catheter were in group 2. They were followed up for more than 6 months. Their in/out flow rate of dialysate, infection at tunnel and exit-site, catheter dislocation and dialysate leakage were observed. Results There were no differences in flow rate of dialysate drainage and infection rate at tunnel and exit-site between group 1 and group 2 (P>0.05). Tenckhoff-coil catheter was often replaced by swan-neck straight type catheter due to the higher dislocation rate associated with the former catheter (17.8% vs. 5%). Conclusion Catheter dislocation rate was lower in patients using swan-neck straight type catheter than in those using Tenckhoff-coil catheter. However, swan-neck straight type catheter was often associated with inadequate drainage or blockage. The drainage efficiency of swan-neck straight type catheter can be significantly improved after adjustment of the angle between outer segment of the tube and abdomen median line during insertion of the catheter.

Key words: Insertion of catheter, Tenckhoff-coil catheter, Swan-neck straight catheter

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