两种腹膜透析置管术的疗效比较

A comparison of two methods for catheterization in peritoneal dialysis

目的比较常规外科手术与腹腔镜手术腹膜透析(腹透)置管的疗效。方法首次置管并接受腹透治疗的患者116例,随机均分为常规手术组(A组)和腹腔镜组(B组),随访2年,记录术后并发症及临床结局。结果 A、B组1年技术存活率相仿(84.5%vs.94.8%)(P>0.05),A组2年技术存活率明显低于B组(65.5%vs.86.2%)(P<0.05)。A组发生腹膜炎5例,B组1例;A组发生机械并发症17例,多于B组的6例(P<0.05)。结论腹腔镜下腹透置管患者技术存活率高,并发症少,尤其适合于腹部情况复杂的肾衰患者。

Objective To compare the efficacy of two methods for catheterization in the patients with end-stage renal disease（ESRD） undergoing peritoneal dialysis.Methods One hundred and sixteen ESRD patients were equally randomized into two groups of A（catheter implantation with conventional technique） and B（catheter implantation with lapoaroscopy）.The patients were followed up for 2 years.The clinical outcomes and postoperative complications were recorded.Results One-year technology survival rate of group A was similar to that of group B（84.5% vs.94.8%）.Two-year technology survival rate of group A was lower than that of group B（65.5% vs.86.2%）（P0.05）.Peritonitis occurred in 5 cases of group A and in 1 case of group B.The mechanical complication was more in group A than that in group B（17 cases vs.6 cases）（P0.05）.ConclusionCompared to conventional technique,placement of peritoneal dialysis catheter by laparoscopy has the advantages of higher technology survival rate and less mechanical complications,which is particularly suitable for ESRD patients with complicated abdominal conditions.