不同腹膜透析导管治疗尿毒症病人的临床观察.docxVIP

不同腹膜透析导管治疗尿毒症病人的临床观察 张荣嘉熊焰 沈阳市苏家屯区中心医院 辽宁省沈阳市红十字会医院肾内科(沈阳M0013) 【摘 要】目的 比较Tenckhoff 管与卷曲管在维持性腹膜透析患者中的临床 疗效。方法 对行腹膜透析置管术的￡3例成人慢性肾衰竭病例进行回顾性分析, 根据其所使用的腹透置管类型不同，将病人分为末端直管组(68例)和卷曲管组 (65例)两组，统计其腹膜透析引流速度、并发症、牛存时间、退出透析或死亡等 结局并进行比较。结果 两组患者腹膜透析的隧道口感染率、腹膜透析液引流速 度、牛存时间等无差别(Pgt；0.05)o术后2周内导管移位共5例，其中卷曲管 4例，直管1例，两组比较有统计学意义(Plt;0.05)o入液时疼痛，直管组7 例，卷曲管组1例，两组比较有统计学意义(Plt;0.05)o结论Tenckhoff直管与 卷曲管均适用于CAPD患者，各有优缺点，建议个体化选择腹膜透析用管。 【关键词】腹膜透析；导管；临床观察 Clinical observation of peritoneal dialysis using different catheter on chronic renal failure patients Luan Xun-fei,Xiong Yan..Department of Nephrology,Shenyang Red Cross Hospital,Shenyang 110013,China Abstract Objective To compare the efficacy between the straight and coiled Tenckhoff catheters in continuous ambulatory peritoneal dialysis (CAPD) patients with end-stage reneal disease (ESRD) for the development of peritoneal dialysis.Methods The 133 cases with adult chronic renal failure patients on PD were retrospective analyzed,according to the different dialysis catheter, devided into straight and coiled group. Compare their out flow rate of dialysate,complications,survival times,quit of dialysis or death,ect.Result There were no differences in infection rate at tunnel exitsite, flow rate of dialysate drainage and survival time between the two groups (Pgt;0.05). Catheter migration occurred in 5 patients in 2 weeks after surgery,coiled 4 and straight l(Plt;0.05).Pain in 8 cases in pouring into the liquid,straight 7 and coined 1(Plt;0.05).C on elution The straight and coiled Tenckhoff catheters are suitable for continuous ambulatory peritoneal dialysis (CAPD) patients.Coiled catheter is not better than that of straight catheter. Key words Peritoneal dialysis； Tenckhoff catheters； clinical observation 腹膜透析(PD)作为慢性肾衰竭患者的治疗措施,近十年来呈明显上升 趋势。如何提高腹膜透析患者长期治疗的成功率，始终是腹膜透析工作者致力于 研究的热点问题。文献报道，由于导管相关并发症引发的PD技术失败已经接近 整体技术失败的20% [l]o因此，置管问题越来越引起临床医生的重视。本文分 别对末端直管和卷曲管植入后，引流速度、入液疼痛、并发症、生存吋间、退出 透析或死亡等进行比较，对提高腹膜透析患者长期治疗具有积极的临床意义。 1对象与方法 1.1研究对象 冋顾性分析，我院肾内科2003年