改良式"薅除式"腹膜透析拔管术初探

Preliminary study on improved"pull technique"for peritoneal dialysis extubation

目的介绍改良式薅管技术及其在上海交通大学附属第一人民医院的初步应用。方法上海交通大学附属第一人民医院自2018年3月起开始实施"薅除式"拔管,在1例患者发生了术后隧道口感染的事件后,我们改良了手术方式:即拔管成功后,在隧道口行小切口,适当修剪皮肤并缝合,使隧道口闭合。结果截至2020年5月,上海交通大学附属第一人民医院合计对15例患者实施改良式薅管,随访期间(0~25个月),无继发感染、腹腔渗液。结论对于符合薅管指征患者,改良式薅管是一个可以尝试的方法,可降低继发感染及腹腔渗液等风险。

Objective To introduce the improved"pull technique"and its preliminary application in Shanghai General Hospital,Shanghai Jiao Tong University School of Medicine.Methods Shanghai General Hospital,Shanghai Jiao Tong University School of Medicine has started to implement the"pull technique"since March 2018.After one patient suffered from postoperative tunnel infection,we′ve improved the operation method:after successful extubation,small incision was made at the tunnel entrance,and the skin was properly trimmed and sutured to close the tunnel entrance.Results Until May 2020,Shanghai General Hospital,Shanghai Jiao Tong University School of Medicine has implemented the modified tube removal for 15 patients.During the follow-up period(0-25 months),there was no secondary infection or peritoneal effusion.Conclusion For patients who meet the indications of"pull technique",the improved"pull technique"is a trial method,which can reduce the risk of secondary infection and peritoneal effusion.