经皮肾镜穿刺用微创扩张引流套件在腹腔穿刺置管引流中的应用

Clinical application of the minimally invasive dilatation for the closed drainage in abdominal paracentesis catheter system

目的探讨微创扩张引流套件在腹腔穿刺置管引流术中的作用,解决一般穿刺置管法放置的引流管管腔偏小,容易堵塞的问题。方法总结我院2005-2010年腹腔穿刺置管引流的病例46例,其中应用Sedinger法留置中心静脉导管作腹腔引流管者29例(甲组),应用微创扩张引流套件扩张后留置单腔导尿管作为腹腔引流管者17例(乙组)。比对两种方法在负性事件(包括管道堵塞、出血、腹腔脏器损伤、管周多量渗液)方面的差异。结果应用微创扩张引流套件组管道堵塞率低于应用中心静脉导管组,差异有统计学意义(P<0.05)。在所统计其他负性事件发生率方面,两组差异无明显统计学意义。结论微创扩张引流套件在腹腔穿刺置管术中引流效果良好,并发症发生率低,在注意操作技巧及腹壁解剖特点的情况下有较高的可行性、安全性及实用性。

Objective To explore the application of the minimally invasive dilatation for the closed drainage in abdominal paracentesis catheter system.Methods 46 inpatients were enrolled in the study.29 cases were inserted central venous duct through salinger method for peritoneal cavity drainage,and 17 cases were applied the minimally invasive dilatation for the closed drainage with Foley＇s duct.The rate of negative occurrence was compared between two groups,including duct blocking,intra-abdominal bleeding,organs injury and extra leakage around duct.Results Duct blocking was less happened in the group which applied the minimally invasive dilatation for the closed drainage（P〈0.05）.Conclusion The minimally invasive dilatation for the closed drainage in abdominal paracentesis catheter system has good effect and low occurrence of complication,with higher safety,feasibility and practicability.