Clinical therapeutic effect of catheter removal and immediate replacement of a new one on uremic patients with maintenance peritoneal dialysis
10.3969/j.issn.1008-9691.2017.06.022
- VernacularTitle:尿毒症维持性腹膜透析患者拔管立即重置对临床疗效的影响
- Author:
Yan XIONG
1
;
Xunfei LUAN
;
Yi HAN
Author Information
1. 沈阳市红十字会医院肾内科
- Keywords:
Uremia;
Peritoneal dialysis;
Peritonitis;
Catheter reset
- From:
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
2017;24(6):654-656
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the clinical therapeutic effect of catheter exchange method and selection of opportunity on uremic patients with peritoneal dialysis (PD).Methods The clinical data of 15 uremia patients with PD and catheter exchange admitted to the Department of Nephrology of Shenyang Red Cross Hospital from June 2006 to June 2015 were retrospectively analyzed, their reasons of extubation reset were reviewed and the prognoses of the patients after re-catheterization were observed.Results In 15 cases the patients, there were 2 cases due to omentum wrapping and 13 cases due to recurrent peritonitis, open surgery was applied to remove the catheter and immediately a new one was re-implanted on the same side through the original incision (12 cases) or on the opposite side through a new incision (3 cases). The surgical results in all the patients were successful without any infection at abdominal incision or tunnel of the tube. After the surgery of catheter exchange for a few months, difficulty in fluid flow through the catheter occurred in 2 patients with omentum wrapping, and they changed to undergo hemodialysis (HD). One patient with recurrent peritonitis died of cerebrovascular disease accident after catheter implantation for two weeks. The situations of patients with multiple episodes of peritonitis were effectively controlled, the positive signs disappeared, the routine laboratory examination of abdominal fluid returned to normal, the fluid bacterial culture negative, and these cases had no relapsing peritonitis any more within 1 year after catheter exchange.Conclusions The method of extubation and immediate re-implantation with a new catheter is applied in uremic PD patients. It is not necessary to use excessive HD to relieve the patients' suffering, thus the patient can avoid reoperation and pay more medical expense. Moreover, the postoperative effect of this catheter exchange is confirmed, and no risk of increasing infection at the surgical incision, tunnel and abdominal cavity is seen.
