腹膜透析管浅涤纶套外露的形成原因分析与护理

The causes and nursing for exposure of Dacron cuff on peritoneal dialysis catheter

目的分析腹膜透析患者腹膜透析管浅涤纶套外露的原因及护理体会。方法收集解放军第四五五医院肾脏科2005年1月至2010年1月间腹膜透析患者380例,回顾性分析其中发生腹膜透析管浅涤纶套外露的10例患者的形成原因。380例腹膜透析患者均采用常规的腹膜透析手术方法,术后常规护理。采用百特鹅颈腹膜透析管,百特双联腹膜透析液。将其中发生了浅涤纶套外露的10例患者按手术因素,护理因素,自身因素与其他因素进行分析阐述。结果因手术因素造成涤纶套外露的1例,护理因素造成涤纶套外露的1例,自身因素造成涤纶套外露的8例。结论腹膜透析患者浅涤纶套外露临床发生较少,但对患者的生活质量、生存率及腹膜透析治疗持续时间等影响较大,应引起临床重视。我们通过加强换药,个别指导,加强营养,皮下隧道延长等措施后,未发生腹膜炎、腹膜透析拔管等严重并发症及后果。

Objective To analysis the causes for the exposure of Dacron cuff on peritoneal dialysis catheter and the nursing experience on the exposure.Method We collected 380 peritoneal dialysis patients from Jan.2005 to Jan.2010 in this hospital,and retrospectively analyzed the causes for the exposure of Dacron cuff on peritoneal dialysis catheter in 10 cases among the 380 peritoneal dialysis patients.All of the peritoneal dialysis patients were treated with routine peration and routine nursing after the operation.Baxter goose neck peritoneal dialysis catheter and Baxter double dialysate were used for these patients.The causes for Dacron cuff exposure were analyzed in association with the factors of operation,nursing,patients and others.Result Dacron cuff exposure caused by operation factor was found in one case,nursing factor in one case,and patients?factor in 8 cases.Conclusion The exposure of Dacron cuff on peritoneal dialysis catheter is uncommon.We should carefully monitor the happening of this complication because of its influences to life quality,survival rate and persistency of peritoneal dialysis in peritoneal dialysis patients.Careful dressing change,appropriate education,better nutrition and extension of subcutaneous tunnel are effective measures to prevent this sever complication and its consequences such as peritonitis and catheter loss.