腹透導(dǎo)管技術(shù)并發(fā)癥

腹膜透析導(dǎo)管技術(shù)的相關(guān)問(wèn)題腹膜透析導(dǎo)管種類導(dǎo)管置入技術(shù)目前存在的問(wèn)題腹膜透析早期與晚期失敗的原因由無(wú)毒的惰性材料制成,可彎曲,質(zhì)量穩(wěn)定具備高的光潔度,能夠有效避免微生物在其表面聚集而發(fā)生腹膜炎不透X線,便于影像學(xué)檢查不受體溫、透析液酸堿度、透析液成分及消毒劑的影響而發(fā)生質(zhì)量改變,以防止長(zhǎng)期使用過(guò)程中發(fā)生化學(xué)性腹膜炎和異物反應(yīng)導(dǎo)管應(yīng)在皮下和腹膜上兩個(gè)部位牢固地與組織結(jié)合,以有效防止漏液和皮下隧道感染具有良好的生物相容性,不易被大網(wǎng)膜包裹。理想的腹膜透析導(dǎo)管?Siliconerubber(nearlyallcatheters)?Polyurethane(Cruzcatheter)TwomainmaterialsTheMostCommonlyUsedCatheters,byInnerandOuterShaftShape(A)Flex-NeckTenckhoffcatheter,silicone(Medigroup,Oswego,IL,U.S.A.);(B)CruzTenckhoffcatheter,polyurethane;(C)StandardTenckhoffcatheter,silicone;(D)OneintraperitoneallimboftheT-flutedcatheter(AshAdvantage:AshAdvantageTechnology,Lafayette,IN,U.S.A.),silicone.FromS.Ash,withpermission.2.6mm,thestandardsizeoftheTenckhoffcatheter,swan-neckcatheter,Missouriswan-neckcatheter,andTWHcatheter3.1mm(Cruzcatheter)3.5mm[Flex-Neck(Medigroup,Oswego,IL,U.S.A.)andAshAdvantagecatheters]BMI>35腹膜透析導(dǎo)管種類導(dǎo)管置入技術(shù)目前存在的問(wèn)題腹膜透析早期與晚期失敗的原因外科手術(shù)置管法腹腔鏡置管法X線透視下置管術(shù)導(dǎo)管置入技術(shù)腹膜透析導(dǎo)管種類導(dǎo)管置入技術(shù)目前存在的問(wèn)題腹膜透析早期與晚期失敗的原因PD置管過(guò)程中常見(jiàn)的并發(fā)癥內(nèi)臟損傷導(dǎo)管移位網(wǎng)膜包裹導(dǎo)管透析管出水不暢透析液滲漏疝腹膜炎及出口處感染麻醉意外導(dǎo)管位置不良移位堵塞或包裹所致的腹膜透析液引流不暢腹膜透析液滲漏疝機(jī)械并發(fā)癥Chronicperitonealdialysisinchildren:catheterrelatedcomplications.AsinglecentreexperiencePediatrSurgInt(2006)22:524–528Causesofcatheterremoval血脂代謝紊亂與腹膜透析置管大網(wǎng)膜包裹的關(guān)系中國(guó)血液凈化2008年3月第7卷第3期

選擇中南大學(xué)湘雅醫(yī)院腎內(nèi)科收集腹膜透析置管術(shù)后發(fā)生大網(wǎng)膜包裹病例15例，以同期未發(fā)生大網(wǎng)膜包裹病例30例為對(duì)照，對(duì)比二組發(fā)生血脂代謝紊亂的差異。同時(shí)，以是否存在血脂代謝紊亂分組，對(duì)比腹膜透析置管術(shù)后大網(wǎng)膜包裹的發(fā)生率。血脂代謝紊亂組20例，網(wǎng)膜包裹11例，網(wǎng)膜包裹率55%血脂代謝正常組25例，網(wǎng)膜包裹4例，網(wǎng)膜包裹率16%前者較后者顯著升高，P＜0.05，差異有統(tǒng)計(jì)學(xué)意義。按照有無(wú)血脂代謝紊亂分組比較網(wǎng)膜包裹發(fā)生情況PATIENTCHARACTERISTICSASSOCIATEDWITHDEFECTSOFTHEPERITONEALCAVITYBOUNDARYPeritonealDialysisInternational,Vol.25,pp.367–373Othercomplicationsincludedpericatheterorsubcutaneousleak,hydrothorax,andmiscellaneous.200ofthesepatientsexperiencedatotalof217anatomiccomplications16patientshadmorethan1complication.Herniascomprised60.4%ofallcomplications:24.9%inguinal,18.9%umbilical,13.8%ventral,2.3%femoral,and0.5%intrathoracic.Othercomplicationsincludedpericatheterorsubcutaneousleak(25.3%),hydrothorax(6.0%),andmiscellaneous(8.3%).PeritonealdialysismodalitiesinuseatthetimeofcomplicationwereautomatedPD(52.3%),continuousambulatoryPD(38