| 汪焱,王利峰,姚国明,胡日红,王星星,黄加力,应波.非切口水囊法与传统术式拔除带隧道和涤纶套的透析导管的临床应用比较[J].浙江中西医结合杂志,2024,34(7): |
| 非切口水囊法与传统术式拔除带隧道和涤纶套的透析导管的临床应用比较 |
| Comparison of clinical application between non-incisional water bag method and traditional tunneling and polyester sheath removal for hemodialysis catheter |
| 投稿时间：2023-06-19 修订日期：2024-04-26 |
| DOI： |
| 中文关键词: 血液透析 带隧道和涤纶套的透析导管 拔除方式 非切开水囊法。 |
| 英文关键词:Hemodialysis Tunneled cuffed catheter Removal method Non-incisional water bag method. |
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| 中文摘要: |
| 目的：探讨非切口水囊法拔除带隧道和涤纶套的透析导管（简称TCC导管）的临床应用优势及安全性。方法：回顾性收集筛选2019年7月5日-2023年2月14日在杭州市中医院肾内科拔除且留管时间≥3个月TCC患者的临床资料、手术方案及并发症等，根据术式将患者分为非切口水囊组（非切口组）和传统切口组（传统组），比较两组患者基础数据、手术成功率、手术时长、术后创面敷料覆盖时间、并发症等。结果：入选病例110例次，传统组35例，非切口囊组75例。术前资料：两组在性别、基础肾脏病、留置导管部位、导管品类方面无明显统计学差异（P＞0.05）；患者年龄分布及拔管原因方面存在差异。手术资料：非切口组与传统组在手术成功率上无明显统计学差异（98.66%/100%，χ2＝0.471，P＝0.493）、手术操作时间有明显统计学差异（6.04±3.91min/18.49±3.55min，t＝16.01，P＜0.00）、术后创面敷料覆盖时间存在统计学差异（3.12±0.65天/7.11±0.53天，t＝31.49，P＜0.001）。安全性：两组并发症发生率无统计学意义（χ2＝0.003，P＝0.954）。结论：非切口水囊法与传统切口法在拔除TCC成功率和安全性方面无明显差异，但前者在缩短操作时间、减少创面、缩短创面恢复时间方面优于传统切口法。 |
| 英文摘要: |
| Objective: To explore the clinical application advantages and safety of the non-incision water-bag method for removing tunnelled cuffed catheter (TCC catheter) with polyester sheath in hemodialysis patients. Methods: General clinical data, surgical plans，and clinical complications of patients who underwent TCC catheter removal and had a retention time of≥3 months in the Department of Nephrology at Hangzhou Hospital of Traditional Chinese Medicine from July 5,2019 to February 14,2023 were retrospectively collected and screened. Patients were divided into the non-incision water-bag group and the traditional incision group according to the surgical method. The basic data，surgical success rate，surgical time, postoperative wound dressing coverage time，and complications were compared between the two groups. Results:A total of 110 cases were selected，including 35 cases in the traditional group and 75 cases in the non-incision water-bag group. There were no significant differences in basic data such as gender, basic kidney disease, catheter placement site, and catheter type between the two groups (P> 0.05). However, there were differences in the reasons for catheter removal and patient age. There was no significant difference in surgical success rate between the two groups (98.66%/100%,χ2=0.471, P=0.493). The surgical operation time was significantly different between the two groups (6.04±3.91 min/18.49±3.55min，t=16.01,P<0.001). The postoperative wound dressing coverage time was statistically different between the two groups (3.12±0.65 days/7.11±0.53 days, t=31.49,P<0.001). There was no significant difference in the incidence of complications between the two groups (χ2=0.003, P=0.954). Conclusion: The non-incision water-bag method and the traditional incision method have no significant difference in the success rate and safety of TCC catheter removal. However, the former is superior to the latter in shortening the operation time, reducing the wound size, and shortening the wound recovery time.
Keywords: Hemodialysis; Tunneled cuffed catheter; Removal method; Non-incisional water bag method. |
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