CAJ | 학술논문

目的比较腹膜透析置管术中不同置管方法对置管成功率、导管通畅性及术后并发症、导管生存率的影响.方法回顾性分析198例行腹膜透析置管术并长期随访的持续不卧床腹膜透析(CAPD)患者,其中应用导丝置管108例,卵圆钳置管90例.统计术中的置管重复次数、导管首次通畅率,观察术后腹腔出血发生率、腹壁渗液发生率、导管移位率以及导管生存率.结果导丝置管重复次数为2.80±0.82次,卵圆钳置管重复次数为1.30 ±0.56次,差异有显著性(P＜0.05);术中导管首次通畅率分别78.7％和91.1％.差异有显著性(P＜0.05);术后腹腔出血发生率分别是7.41％和0,差异有显著性(P＜0.05);腹壁渗液分别有2例和4例,差异无显著性(P＞0.05);术后1年内导管移位发生率分别为11.5％和4.3％,差异有显著性(P＜0.05);术后1年导管生存率分别为93.5％和100％,差异有显著性(P＜0.05).结论在腹膜透析置管手术中采用卵圆钳置管能够更为准确将导管置入目标位置,提高置管成功率,减少腹腔出血并发症,改善术后导管通畅性、降低术后导管移位以及提高导管生存率,值得推广应用.
목적 비교복막투석치관술중불동치관방법대치관성공솔、도관통창성급술후병발증、도관생존솔적영향.방법 회고성분석198례행복막투석치관술병장기수방적지속불와상복막투석(CAPD)환자,기중응용도사치관108례,란원겸치관90례.통계술중적치관중복차수、도관수차통창솔,관찰술후복강출혈발생솔、복벽삼액발생솔、도관이위솔이급도관생존솔.결과 도사치관중복차수위2.80±0.82차,란원겸치관중복차수위1.30 ±0.56차,차이유현저성(P＜0.05);술중도관수차통창솔분별78.7％화91.1％.차이유현저성(P＜0.05);술후복강출혈발생솔분별시7.41％화0,차이유현저성(P＜0.05);복벽삼액분별유2례화4례,차이무현저성(P＞0.05);술후1년내도관이위발생솔분별위11.5％화4.3％,차이유현저성(P＜0.05);술후1년도관생존솔분별위93.5％화100％,차이유현저성(P＜0.05).결론 재복막투석치관수술중채용란원겸치관능구경위준학장도관치입목표위치,제고치관성공솔,감소복강출혈병발증,개선술후도관통창성、강저술후도관이위이급제고도관생존솔,치득추엄응용.
Objectives To compare the success rate,patency,postoperative complications and survival rate of the catheter between two different methods applied in peritoneal dialysis(PD) catheter insertion.Methods 198 cases of PD patients were enrolled retrospectively,and grouped into A and B.90 cases of group A were applied with oval forceps and 108 cases of group B with guide wire during tube grafting in the PD operations.The number of grafting replication and the first time tube patency were counted during operation,while as the incidence rate of intraperitoneal hemorrhage,abdominal effusion,catheter displacement and catheter survival rate were observed after operation.Results The number of replication in group A was 2.80 ± 0.82,and 1.30-± 0.56 in group B.For group A and B,the first time tube patency rate was 78.7％ and 91.1％,the incidence rate of intraperitoneal hemorrhage was 7.41％ and zero,the one year catheter displacement rate was 11.5 ％ and 4.3 ％,and the one year catheter survival rate was 93.5％ and 100％.There was significant difference between the two grafting methods in the above indexes,P ＜ 0.05.However,the abdominal effusion rate had no significant difference,P ＞ 0.05.Conclusions The oval forceps applied in PD catheter insertion can locate the tube to the target position more exactly with higher success rate,tube patency rate,survival rate and less postoperative complications including intraperitoneal hemorrhage,catheter displacement.The method deserves to be promoted.