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目的:探讨腹部和盆腔手术史对终末期肾病(ESRD)患者腹膜透析(PD)导管放置的影响。方法:前瞻性观察111例ESRDPD治疗患者,比较有无先前腹部和盆腔手术史对PD置管手术短期和长期并发症发生率的影响。结果:111例ESRD患者中,25例原先有腹部和盆腔手术史(A组),86例无腹部和盆腔手术史(B组)。置管术后各类PD并发症,如血性腹透液、腹透管异位、腹透液渗漏、腹部疼痛、出口处感染、腹膜炎、腹透管堵塞、阴囊肿胀等的发生例数在A组分别为2(8.0%)、0(0)、1(4.0%)、3(12.0%)、0(0)、4(16.0%)、0(0)、0(0),而B组分别为3(3.5%)、2(2.3%)、3(3.5%)、8(9.3%)、0(0)、11(12.8%)、2(2.3%)、1(1.2%),2组差异无统计学意义。结论:既往腹部和盆腔手术史对ESRD患者PD导管放置后短期和长期并发症的发生率没有显著影响。但置管术前应谨慎评估患者腹腔粘连情况,术中细致操作。
Objective: To investigate the effect of abdominal and pelvic surgery on peritoneal dialysis (PD) catheterization in patients with end-stage renal disease (ESRD). METHODS: A prospective study of 111 ESRDPD-treated patients was performed to compare the effects of previous abdominal and pelvic surgical procedures on the incidence of short-term and long-term complications in PD catheterization. Results: Of the 111 patients with ESRD, 25 had a previous history of abdominal and pelvic surgery (group A) and 86 had no history of abdominal and pelvic surgery (group B). Postoperative complications of various types of PD, such as bloody peritoneal dialysis, peritoneal dialysis, peritoneal leakage, abdominal pain, infection at the outlet, peritonitis, peritoneal plug, swelling of the scrotum Group A were 2 (8.0%), 0 (0), 1 (4.0%), 3 (12.0%), 0 (0), 4 (16.0%), 0 (0), 0 The groups were 3 (3.5%), 2 (2.3%), 3 (3.5%), 8 (9.3%), 0 (0), 11 (12.8%), 2 (2.3%), 1 There was no significant difference between the two groups. CONCLUSIONS: Previous abdominal and pelvic surgical history had no significant effect on the incidence of short-term and long-term complications after PD catheter placement in ESRD patients. However, preoperative catheterization should be carefully evaluated patients with abdominal adhesions, intraoperative meticulous operation.