腹透导管技术并发症.pptVIP

腹膜透析导管技术的相关问题;腹膜透析导管种类 导管置入技术 目前存在的问题 腹膜透析早期与晚期失败的原因;由无毒的惰性材料制成, 可弯曲, 质量稳定 具备高的光洁度, 能够有效避免微生物在其表面聚集而发生腹膜炎 不透 X 线, 便于影像学检查 不受体温、 透析液酸碱度、透析液成分及消毒剂的影响而发生质量改变, 以防止长期使用过程中发生化学性腹膜炎和异物反应 导管应在皮下和腹膜上两个部位牢固地与组织结合, 以有效防止漏液和皮下隧道感染 具有良好的生物相容性, 不易被大网膜包裹。;? Silicone rubber (nearly all catheters) ? Polyurethane (Cruz catheter);The Most Commonly Used Catheters, by Inner and Outer Shaft Shape;(A) Flex-Neck Tenckhoff catheter, silicone (Medigroup, Oswego,IL, U.S.A.); (B) Cruz Tenckhoff catheter, polyurethane; (C) Standard Tenckhof f catheter, silicone; (D) One intraperitoneal limb of the T-fluted catheter (Ash Advantage: Ash Advantage Technology, Lafayette, IN, U.S.A.), silicone. From S. Ash, with permission.; BMI 35 ;腹膜透析导管种类 导管置入技术 目前存在的问题 腹膜透析早期与晚期失败的原因;外科手术置管法 腹腔镜置管法 X线透视下置管术;腹膜透析导管种类 导管置入技术 目前存在的问题 腹膜透析早期与晚期失败的原因;PD置管过程中常见的并发症;导管位置不良 移位 堵塞或包裹所致的腹膜透析液引流不畅 腹膜透析液渗漏 疝;Chronic peritoneal dialysis in children: catheter related complications. A single centre experience; Causes of catheter removal;血脂代谢紊乱与腹膜透析置管大网膜包裹的关系;血脂代谢紊乱组20例， 网膜包裹11例，网膜包裹率55% 血脂代谢正常组25例，网膜包裹4例，网膜包裹率16% 前者较后者显著升高，P ＜0.05，差异有统计学意义。;PATIENT CHARACTERISTICS ASSOCIATED WITH DEFECTS OF THE PERITONEAL CAVITY BOUNDARY;Other complications included pericatheter or subcutaneous leak, hydrothorax, and miscellaneous.;200 of these patients experienced a total of 217 anatomic complications 16 patients had more than 1 complication. Hernias comprised 60.4% of all complications: 24.9% inguinal, 18.9% umbilical, 13.8% ventral, 2.3% femoral, and 0.5% intrathoracic. Other complications included pericatheter or subcutaneous leak (25.3%), hydrothorax (6.0%), and miscellaneous (8.3%). Peritoneal dialysis modalities in use at the time of complication were automated PD (52.3%), continuous ambulatory PD (38.6%), and nocturnal intermittent PD (9.1%). The overall incidence of hernias was 7%.;腹膜透析导管种类 导管置入技术 目前存在的问题 腹膜透析早期与晚期失败的原因;CONTRIBUTION OF EARLY FAILURE TO OUTCOME ON PERITONEAL DIALYSIS;To analyze the importance of early treatment