大网膜部分切除在腹腔镜腹膜透析管置入术的应用价值

Value of partial omentectomy in laparoscopic peritoneal dialysis catheter placement

目的探讨大网膜部分切除术在慢性肾脏病5期患者腹膜透析管置入术中的应用价值。方法选择郑州大学第一附属医院腹腔镜外科于2017-01—2019-08间收治的268例慢性肾脏病5期患者,其中190例行常规腹腔镜下腹膜透析管植入术(常规腹腔镜组)、78例行腹腔镜下腹膜透析管置入并大网膜部分切除术(大网膜切除组)。对2组患者的临床资料进行比较分析。结果2组患者的年龄、性别、术前血红蛋白、术前肌酐值等一般资料差异无统计学意义(P>0.05)。268例手术均获成功,大网膜切除组手术时间长于常规腹腔镜组,手术费用多于常规腹腔镜组;常规腹腔镜组堵管10例,大网膜切除组无堵管病例。差异均有统计学意义(P<0.05)。结论腹腔镜下腹膜透析管置入并大网膜部分切除术,对预防术后大网膜包裹腹膜透析管效果良好,具有临床应用价值。

Objective To discuss the value of partial omentectomy in peritoneal dialysis in patients with stage 5 chronic kidney disease.Methods A total of 268 patients with stage 5 chronic kidney disease from January 2017 to August 2019 in the laparoscope surgery department of the First Affiliated Hospital of Zhengzhou University were selected,of which 190 patients underwent conventional laparoscopic peritoneal dialysis catheter placement,and 78 patients underwent laparoscopic peritoneal dialysis catheter placement and omentum partial resection,comparative analysis of the clinical data of the two groups of patients.Results There was no statistically significant difference in patient’s general data including age,gender,preoperative hemoglobin level,and preoperative creatinine level between the two groups(P>0.05).268 cases were successfully completed.The operation time of the omentum resection group was longer than that of the conventional laparoscopic group;the operation cost of the omentum resection group was more than that of the conventional laparoscopic group;10 cases of catheter obstruction occurred in the conventional laparoscopic group;no catheter obstruction occurred in the omentum resection group(P<0.05).Conclusion Laparoscopic peritoneal dialysis catheter placement and omentum partial resection has a good effect on the prevention of postoperative omentum wrapping peritoneal dialysis catheter,and has clinical application value.