非手术法腹膜透析管复位护理技巧在腹膜透析患者导管移位中的应用

The application of non- operative method nursing skills for peritoneal dialysis catheter displacement

目的 总结上海瑞金医院腹膜透析管移位的发生情况及非手术复位的护理经验. 方法 分析上海瑞金医院腹膜透析患者2007～2011年5年内导管移位发生原因,并根据腹腔段导管形状分成直管组与卷曲管组比较2组导管复位情况. 结果 ①5年内发生导管移位患者48例,占总人数的14.96％.②直管组导管移位发生率为12.64％,卷曲管组发生率为29.55％.③分析导管移位原因便秘占首位.④发生导管移位后采取非手术方法复位成功率为75％,其中直管组非手术复位成功率为97.10％,卷曲管组为15.40％,直管组的非手术复位成功率要显著高于卷曲管组（x2=33.790,P＜0.05）.结论 发生导管移位后可先使用非手术方法复位.

Objective To summarize the incidence of peritoneal dialysis catheter migration and nursing experience of non-operative catheter replacement.Methods We calculated the success rate of non-operative replacement,analyzed the related risk factors of catheter displacement,and discussed the importance of nursing instruction for catheter replacement.Results Catheter shift occurred in 48 （14.96％） patients during follow-up.Constipation was the main reason causing catheter displacement.The success rate of replacement by non-operative nursing method was higher in straight group than in curly group （97.10％ vs.15.40％,x2=33.790,P＜0.05）.Conclusions Curled catheter had a higher catheter tip migration rate and was less likely to be repositioned by non-operative method than straight catheter.The nursing experience played an important role during catheter reposition.