高位腹膜透析置管术与改良型低位腹膜透析置管术的临床应用比较

Clinical Application Comparison of High Peritoneal Dialysis Catheter and Modified Low Peritoneal Dialysis Catheter

目的比较高位腹膜透析置管术与改良型低位腹膜透析置管术的临床应用情况。方法方便选取该院于2014年1月—2016年12月间该院需行腹膜透析置管术患者50例,将所有患者随机分为两组,每组25例。高位腹膜透析置管术组采用高位腹膜透析置管术治疗,改良型低位腹膜透析置管术组采用低位-直管模拟鹅颈隧道成型置管术治疗。比较两组患者的手术情况、手术并发症情况以及漂管率、堵管率情况。结果改良型低位腹膜透析置管术组生存率、生活质量评分均高于高位腹膜透析置管术组患者,但差异无统计学意义(P>0.05)。改良型低位腹膜透析置管术组术中出血量(187.21±1.32)mL较高位腹膜透析置管术组术中出血量(247.21±1.32)mL降低(P<0.05)。改良型低位腹膜透析置管术组手术时间(107.21±1.32)min较高位腹膜透析置管术组手术时间(127.21±1.32)min降低(P<0.05)。改良型低位腹膜透析置管术组术后两周漂管率较高位腹膜透析置管术组降低(0.00%<20.00%)(P<0.05)。改良型低位腹膜透析置管术组术后6个月漂管率较高位腹膜透析置管术组降低(4.00%<24.00%)(P<0.05)。改良型低位腹膜透析置管术组患者术后6个月堵管率较高位腹膜透析置管术组降低(4.00%<24.00%)(P<0.05)。结论改良型低位腹膜透析置管术比高位腹膜透析置管术更能改善手术情况,降低术后漂管率、堵管率,值得进一步临床应用。

Object ive This paper tries to compare the appl icat ion situat ion of high per i toneal dialysis catheter and modified low per i toneal dialysis catheter . Methods 50 cases of pat ients with per i toneal dialysis catheter from January 2014 to De-cember 2016 in this hospi tal were convenient select ion and divided into two groups, with 25 cases in each group. The high per i toneal dialys is catheter group adopted high per i toneal dialysis catheter treatment and the modified low per i toneal dialy-sis catheter group adopted low site and inverse-U-shaped tunnel per i toneal dialys is catheter treatment. After treatment, op-erat ion resul t , surgical complicat ions , catheter migration and catheter blocking in two groups were compared. Results The survival rate and quality of life of the modified low - level per i toneal dialysis group were higher than those of the high per i-toneal dialys is group, but the difference was not stat is t ical ly signif icant （P〉0.05）. The intraoperative blood loss was （187.21± 1.32）mL in the modified low per i toneal dialys is group, lower than that in the high per i toneal dialysis group of （247.21±1.32） mL（P〈0.05）. The operat ive time was（107.21±1.32）min in the modified per i toneal dialysis group, signif icantly lower than that in the control group of （127.21 ±1.32）min （P〈0.05）. The catheter migration af ter two weeks’ operat ion in the low peri toneal dialysis group was 0.00%, lower than that in the high per i toneal dialys is group of 20.00%（P〈0.05） . The catheter migration af ter six months’ operat ion in the modified low-grade per i toneal dialys is group was 4.00%, lower than that in the high per i-toneal dialysis group of 24.00%（P〈0.05）. The catheter blocking of six months’ af ter operat ion in the modified low peri toneal dialysis group was 4.00%, lower than that in the high per i toneal dialysis group of 24.00%（P〈0.05） . Conclusion Compared with high per i toneal dialys is catheter , the modified low per i toneal dialysis catheter can effectively improve the operat ion re-sults, reduce the rate of catheter migration and catheter blocking, which is worth promotion and application.