腹膜透析液引流不畅的原因分析及护理对策

The clinical analysis of inadequate drainage in peritoneal dialysis

目的 通过分析影响持续非卧床腹膜透析（CAPD）患者发生腹膜透析液引流不畅的因素，以减少此并发症的发生及避免其所致的严重后果。方法调查2005年2月至2009年10月在本腹透中心进行CAPD的终末期肾病的临床资料，发生腹膜透析液引流不畅的原因，时间及相应的护理措施对其预后的影响。结果18人次发生腹膜透析液引流不畅。其中最常见的原因是功能性引流不畅，大部分通过保守治疗即可解决。腹膜透析液引流不畅大多发生在腹膜透析的头1个月内。6例需行手术复位。结论腹膜透析液引流不畅的主要原因是功能性引流不畅。因大部分患者发生在术后头1个月内，故需加强围手术期的护理。虽然大部分腹膜透析液引流不畅可保守治疗解决，但仍有一部分患者需行手术复位。植管时透析管放置位置正确和术后积极护理是防止透析液引流不畅的较好方法。

Objective We studied the clinical characteristics that influence the risk of inadequate drainage complication. Methods A retrospective method was used to anlysis the risk factors of inadequate drainage complication.Results Between Feb. 2005 and Oct. 2009.105 CAPD patients were recruited for analysis. During the sutdy period, 18 episodes of inadequate drainage complication were recorded. The most common risk factors of inadequate drainage complication were fibrin plugging, migra- tion and omental wrapping. Most of cases happened in 1 month afteroperating. 6 cases neet to reimplant catheter. Conclusion Our results suggested that in the early postoperating, the nursing should be reinforced to prevent inadequate drainage complication. The most important things to preventing inadequate drainage were the right embedded place and postoperative care.