分离擦拭法和浸泡法腹膜透析外接短管更换方法效果的对比分析

Comparative analysis of the eff ectiveness of separate wiping and soaking methods for the replacement of short external peritoneal dialysis tubes

目的 对比分离擦拭法和浸泡法两种更换短管方式的换管效果及对感染风险、换管耗时和患者舒适度的影响,为临床实际操作提供参考。方法 选取2021年4月-2022年6月在中山市中医院肾内科腹膜透析中心的规律行腹膜透析患者120例为研究对象。按照组间基线资料可比的原则分为浸泡组和擦拭组,各60例。严格按照操作流程换管后,观察并对比两组更换短管所需的时间、成本、外接短管与钛接头连接处的表面菌落生长情况,并随访换管后1周内腹膜透析相关并发症的发生情况,并调查患者换管过程中的舒适度和疲乏情况,比较两种短管更换方试的优缺点。结果 两组患者更换短管时的舒适度比较,差异无统计学意义(P>0.05)。擦拭组更换短管所用时长短于浸泡组,差异有统计学意义(P<0.05);两组患者更换短管时的疲乏程度各维度评分比较,差异均无统计学意义(P>0.05)。两组患者短管更换成本相同均为7.3元,连接处表面均无菌落,均未发生腹膜透析相关并发症。结论 与浸泡法相比,分离擦拭法在保证换管过程的安全性的同时,可节约操作时间,减轻护士工作量,提高工作效率和治疗室空间利用率。

Objective To compare the effects of two methods of changing short tubes,namely the separation wipe method and the immersion method,on the risk of infection,the time consuming for tube changing,and the comfort of the patients,to provide references for the actual clinical operation.Methods 120 patients underwent regular peritoneal dialysis at the Peritoneal Dialysis Centre of the Department of Nephrology,Zhongshan Hospital of Traditional Chinese Medicine from April 2021 to June 2022 were selected for the study.According to the principle of comparable baseline information between groups,they were divided into immersion group and wiping group,60 cases in each group.After tube replacement in strict accordance with the operating procedures,we observed and compared the time required for tube replacement,cost,surface colony growth at the connection between the external short tube and the titanium connector between the two groups,and followed up the occurrence of peritoneal dialysis-related complications within 1 week after tube replacement,as well as investigated the comfort and fatigue of the patients in the process of tube replacement,and compared the advantages and disadvantages of the two short tube replacement methods.Results The difference in comfort level between the two groups of patients during tube replacement was not statistically significant(P>0.05).In the wiping group,the time taken to replace the short tubes was significantly shorter than that of the soaking group,and the difference was statistically significant(P<0.05);the difference in the fatigue scores of the two groups was not statistically significant when compared with the fatigue scores of the two groups of patients when replacing the short tubes(P>0.05).The cost of replacing the short tubes was the same in both groups at 7.3 Yuan,and the surfaces of the joints were free of bacterial colonies,and no complications related to peritoneal dialysis occurred in any of the two groups.Conclusion Compared with the soaking method,the separation wiping method can save the operation time,reduce the workload of nurses,improve the work effciency and treatment room space utilisation while ensuring the safety of the tube replacement process.