两孔法腹腔镜置管术行腹膜透析的临床效果及安全性

Clinical efficacy and safety of two-port laparoscopic catheter placement in peritoneal dialysis

目的:探讨通过两孔法腹腔镜置管术行腹膜透析的临床效果及安全性。方法:回顾分析2018年7月至2021年7月为100例患者行腹膜透析的临床资料,根据治疗方式分为观察组(n=56,两孔法腹腔镜置管术)与开腹组(n=44,传统开腹置管)。比较两组手术情况,记录治疗前、治疗后1个月生化指标(血肌酐、血尿素氮、钙、磷)及生活质量变化,并统计两组不良反应。结果:观察组手术时间、术中出血量、术后疼痛时间、住院时间均少于开腹组,差异有统计学意义(P<0.05);治疗后1个月,两组血肌酐、血尿素氮、钙、磷均较治疗前降低(P<0.05),两组间差异无统计学意义(P>0.05);两组躯体功能、物质生活、情感职能、社会功能等评分均较治疗前升高(P<0.05),观察组上述评分均高于开腹组(P<0.05)。观察组并发症发生率低于开腹组(5.36%vs.18.18%,P<0.05)。结论:通过两孔法腹腔镜置管术行腹膜透析具有微创的特点,可快速缓解疼痛,促进术后康复,提高患者生活质量,安全性较高。

Objective:To investigate the clinical efficacy and safety of two-port laparoscopic catheter placement for peritoneal dialysis(PD).Methods:From Jul.2018 to Jul.2021,clinical data of 100 patients who underwent laparoscopic catheterization for PD were retrospectively analyzed.Based on the treatment methods,patients were divided into the observation group(n=56,two-port laparoscopic catheterization)and the laparotomy group(n=44,traditional laparotomy).The surgical conditions of the two groups were compared,and biochemical indicators such as serum creatinine,blood urea nitrogen,calcium,phosphorus,and quality of life were recorded before and 1 month after treatment.Adverse reactions in both groups were recorded.Results:The operation time,intraoperative bleeding,postoperative pain time,and hospital stay in the observation group were shorter(or lower)than those in the laparotomy group(P<0.05).One month after treatment,the serum creatinine,blood urea nitrogen,calcium and phosphorus of the two groups were lower than those before treatment(P<0.05),but no difference was found between the two groups(P>0.05).One month after treatment,the scores of physical function,material life,emotional function,and social function in the two groups were higher than those before treatment(P<0.05),and the scores in the observation group were higher than those in the laparotomy group(P<0.05).The complication rate in the observation group was 5.36%,which was significantly lower than 18.18%in the laparotomy group(P<0.05).Conclusions:Two-port laparoscopic catheter insertion for PD has the characteristics of minimal invasion and high safety,can quickly relieve pain,promote the early recovery of patients after surgery,and improve the quality of life.