彩超引导下多功能膀胱造瘘穿刺针经皮穿刺腹膜透析置管术的临床研究

Ultrasound-Guided Percutaneous Placement of Peritoneal Dialysis Catheter with Multifunctional Bladder Paracentesis Trocar

目的:探讨多功能膀胱造瘘穿刺针在超声引导下经皮穿刺腹膜透析置管术的临床应用效果。方法:随机选择2016年6月~2017年1月16例慢性肾脏病5期的患者,采用多功能膀胱造瘘穿刺针建立单通道进入腹腔,在B超引导下将Tenckhoff腹透管通过穿刺针外鞘置入膀胱直肠窝或子宫直肠窝,随后观察置管过程中和置管后的状况以及置管后1月内腹膜透析管相关合并症和腹膜透析相关性感染的发生情况。结果:16例患者均成功置入腹膜透析管,切口长度2~4 cm,操作时间10~30分钟,所有患者均未出现明显出血和脏器损伤,术后无需使用镇痛剂,随访6~12个月,无一例患者出现导管相关性并发症。结论:彩超引导下使用多功能膀胱造瘘穿刺针经皮穿刺放置腹膜透析管技术,定位准确,更简单、安全、快速和经济节约,具有独特的优势,值得临床推广应用。

Objective: To investigate the clinical benefit of ultrasound-guided peritoneal dialysis (PD) catheter implantation with multifunctional bladder paracentesis trocar. Methods: 16 patients with CKD5 were enrolled from June 2016 to January 2017. Peritoneal dialysis catheter was placed into rec-tal-bladder-fossa or uterus-rectum-fossa guided by ultrasound through a single channel which is built by multifunctional bladder paracentesis trocar. Then we observe the PD-related complication and PD-related infection during, after and one month after the catheterization. Results: Peritoneal dialysis catheters were implanted successfully in all 16 patients. The length of incision was 2 to 4cm and the time of operation was 10 to 30 minutes. Neither obvious bleeding nor organ injury was found and analgesic wasn’t used after operation. None of the 16 patients exhibited catheter-related complication after 6 to 12 months follow-up visits. Conclusion: The operation of ultrasound-guided PD catheter implantation with multifunctional bladder paracentesis trocar has unique advantage of easy, safe, fast, economical and accurate location, worth clinical promotion.