改进Seldinger法经皮穿刺腹膜透析置管术在终末期肾病患者中的应用

Application of Improved Seldinger Method Percutaneous Peritoneal Dialysis Catheterization in Patients with End-Stage Renal Disease

目的:探讨改进Seldinger法经皮穿刺腹膜透析置管术在终末期肾病患者中的应用效果。方法:选取2019年12月~2020年12月于本院进行腹膜透析置管术的终末期肾病患者61例,随机分为观察组(31例)和对照组(30例),对照组患者采用常规开腹手术置管,观察组采用改进Seldinger法置管,比较两组患者完成置管手术的相关指标(手术时间、术后排气时间、切口长度、住院时间),术后3d、1个月患者并发症发生情况。结果:较对照组,观察组手术时间、术后排气时间均更短,腹部切口长度更短(P<0.05),两组患者住院时间比较(P>0.05),观察组穿刺成功率明显高于对照组(100.00%,80.00%,χ^(2)=6.88,P=0.01)。较对照组,观察组患者术后3d并发症发生率明显低于对照组(22.58%,50.00%,χ^(2)=4.97,P=0.03),观察组患者术后1个月并发症发生率明显低于对照组(19.35%,53.33%,χ^(2)=7.05,P=0.01)。结论:对终末期肾病患者运用改进Seldinger法经皮穿刺腹膜透析置管术进行置管可有效缩短手术时间和术后排气时间,创口较小,患者术后早期、远期并发症较少,临床应用效果较好。

Objective:To explore the effect of improved Seldinger’s percutaneous peritoneal dialysis catheterization in patients with end-stage renal disease.Methods:A total of 61 patients with end-stage renal disease who underwent peritoneal dialysis catheterization in our hospital from December 2019 to December 2020 were randomly divided into observation group(31 cases)and control group(30 cases).The patients in the control group were catheterized by conventional laparotomy,and the patients in the observation group were catheterized by improved Seldinger method.The relevant indexes of the two groups(operation time,postoperative exhaust time,incision length and hospital stay)and the incidence of complications at 3 days and 1 month after operation were compared.Results:Compared with the control group,the observation group had shorter operation time,postoperative exhaust time,shorter abdominal incision length(P<0.05),and the hospitalization time of the two groups was compared(P>0.05),the observation group had a significantly higher successful rate of puncture in the control group(100.00%,80.00%,χ^(2)=6.88,P=0.01).Compared with the control group,the 3-day postoperative complication rate in the observation group was significantly lower than that in the control group(22.58%,50.00%,χ^(2)=4.97,P=0.03),and the incidence of complications in the observation group at 1 month after operation was significantly lower than that in the control group(19.35%,53.33%,χ^(2)=7.05,P=0.01)Conclusion:The improved Seldinger method percutaneous peritoneal dialysis catheter placement for patients with end-stage renal disease can effectively shorten the operation time and postoperative exhaust time,the wound is small,and the patients have fewer early and long-term complications after surgery.The clinical application effect is better.