腹膜透析置管术后早期增量式腹膜透析的应用与护理

Early incremental peritoneal dialysis after catheter implantation and its nursing care

目的 探讨腹膜透析置管术后立即应用增量式腹膜透析进行治疗的效果及安全性.方法 对161例行腹膜透析置管并首次行透析治疗的尿毒症患者,于术后72h～2周采用IPD和CAPD模式行增量式腹膜透析,术后2周逐渐过渡至传统的CAPD,观察其透析效果和早期并发症发生率.结果 置管前、术后3d、术后1个月进行血液生化结果的计较,患者尿素氮、血肌酐、血白蛋白、血清磷及血清钾水平显著降低,而血清钙、二氧化碳结合力显著上升（P＜0.05）.患者术后并发症中腹膜漏、伤口愈合不良、腹壁疝等的发生率为1.0％,飘管和大网膜包裹发生率为2.47％.结论 腹膜透析置管术后立即应用增量式腹膜透析进行治疗是有效及安全的.

Objective To investigate the effect and safety of early incremental peritoneal dialysis after catheter implantation.Methods 161 patients with uremia implanted catheter and taking peritoneal dialysis first time were selected as study objects.They were treated with IPD and CAPD with incremental model 72 hours to 2 weeks after surgery,2 weeks from then the model was transferred to traditional CAPD.The dialysis effect and early complications were observed.Results The levels of blood urea nitrogen,serum creatinine,serum albumin serum phosphorus,and serum potassium were obviously lower and the serum calcium and carbon dioxide combining power were much higher 3 days and 1 month after operation than before catheter implantation in the patients （P 〈 0.05）.The incidence of peritoneal leakage,poor healing,or abdominal mural hernia was 1.0% and that of catheter migration or omental wrap was 2.47%.Conclusions Early incremental peritoneal dialysis after catheter implantation is effective and safe.