腹膜透析管安置术后患者发生大网膜包裹的危险因素分析
发布时间：2018-10-09 16:46
【摘要】：目的探讨腹膜透析管安置术后患者发生腹膜透析管大网膜包裹的危险因素。方法选取2007年1月—2015年12月间在上海长海医院肾内科行常规腹膜透析管安置术的患者626例,其中术后发生大网膜包裹导致引流不畅29例(包裹组),未发生大网膜包裹597例(对照组)。对两组患者的临床资料进行比较,采用Logistic多元回归分析腹膜透析管安置术后大网膜包裹发生的危险因素。结果包裹组中,术后当天发生大网膜包裹2例,术后1~5d发生大网膜包裹4例,术后6~10d发生大网膜包裹10例,术后11~15d发生大网膜包裹10例,术后15d发生大网膜包裹3例。包裹组的BMI、身高和甲状旁腺激素水平均显著低于对照组(P值均0.05),便秘患者构成比、术后疼痛视觉模拟评分均显著高于对照组(P值均0.05),术后下床活动时间(手术结束至患者首次下床活动的时间)显著晚于对照组(P0.05),血钾、三酰甘油和胆固醇水平均显著高于对照组(P值均0.05);两组间切口至耻骨联合距离和血红蛋白、血钙、血清铁、血磷、血清肌酐、白蛋白水平的差异均无统计学意义(P值均0.05)。多因素Logistic回归分析显示,术后疼痛视觉模拟评分(OR=2.311,95%CI为0.975~5.479)、术后下床活动时间(OR=2.192,95%CI为1.337~3.595)和三酰甘油水平(OR=2.160,95%CI为1.427~5.319)是腹膜透析管术后大网膜包裹发生的独立危险因素(P值均0.05)。结论腹膜透析管安置术后大网膜包裹多发生于术后2周以内,术后疼痛视觉模拟评分、下床活动时间和三酰甘油水平是发生腹膜透析管大网膜包裹的独立危险因素。
[Abstract]:Objective to investigate the risk factors of greater omentum encapsulation of peritoneal dialysis tube after peritoneal dialysis tube placement. Methods from January 2007 to December 2015, 626 patients underwent routine peritoneal dialysis tube placement in the Department of Nephrology, Changhai Hospital in Shanghai. There were 29 cases (package group) and 597 cases (control group) with unobstructed drainage caused by greater omentum wrapping after operation. The clinical data of the two groups were compared and the risk factors of omentum encapsulation after peritoneal dialysis tube placement were analyzed by Logistic regression analysis. Results in the package group, there were 2 cases of greater omentum wrapping on the day of operation, 4 cases of greater omentum wrapping on the 5th day after operation, 10 cases of greater omentum wrapping on 610 days after operation, 10 cases of greater omentum wrapping on 1115 days after operation, and 3 cases of greater omentum wrapping on 15 days after operation. The BMI, height and parathyroid hormone level in the package group were significantly lower than those in the control group (P < 0. 05). The visual analogue score of postoperative pain was significantly higher than that of the control group (P < 0.05), and the time of getting out of bed after operation (the time from the end of operation to the first time of the patient getting out of bed) was significantly later than that of the control group (P0.05). The levels of triacylglycerol and cholesterol were significantly higher than those in the control group (P < 0.05), but there was no significant difference in the distance between incision and pubic association and the levels of hemoglobin, serum calcium, serum iron, serum phosphorus, serum creatinine and albumin between the two groups (P < 0.05). Multivariate Logistic regression analysis showed that postoperative pain visual analogue score (OR=2.311,95%CI = 0.975 卤5.479), postoperative time of getting out of bed (OR=2.192,95%CI = 1.337 卤3.595) and triacylglycerol level (OR=2.160,95%CI = 1.427 卤5.319) were independent risk factors of omentum encapsulation after peritoneal dialysis tube operation (P < 0. 05). Conclusion after peritoneal dialysis tube placement, omentum encapsulation mostly occurs within 2 weeks after operation. Visual analogue score of postoperative pain, time of getting out of bed and level of triglyceride are independent risk factors for the occurrence of greater omentum encapsulation of peritoneal dialysis tube.
【作者单位】： 上海长海医院肾内科;
【基金】：国家自然科学基金资助项目(81500583)
【分类号】：R692
[Abstract]:Objective to investigate the risk factors of greater omentum encapsulation of peritoneal dialysis tube after peritoneal dialysis tube placement. Methods from January 2007 to December 2015, 626 patients underwent routine peritoneal dialysis tube placement in the Department of Nephrology, Changhai Hospital in Shanghai. There were 29 cases (package group) and 597 cases (control group) with unobstructed drainage caused by greater omentum wrapping after operation. The clinical data of the two groups were compared and the risk factors of omentum encapsulation after peritoneal dialysis tube placement were analyzed by Logistic regression analysis. Results in the package group, there were 2 cases of greater omentum wrapping on the day of operation, 4 cases of greater omentum wrapping on the 5th day after operation, 10 cases of greater omentum wrapping on 610 days after operation, 10 cases of greater omentum wrapping on 1115 days after operation, and 3 cases of greater omentum wrapping on 15 days after operation. The BMI, height and parathyroid hormone level in the package group were significantly lower than those in the control group (P < 0. 05). The visual analogue score of postoperative pain was significantly higher than that of the control group (P < 0.05), and the time of getting out of bed after operation (the time from the end of operation to the first time of the patient getting out of bed) was significantly later than that of the control group (P0.05). The levels of triacylglycerol and cholesterol were significantly higher than those in the control group (P < 0.05), but there was no significant difference in the distance between incision and pubic association and the levels of hemoglobin, serum calcium, serum iron, serum phosphorus, serum creatinine and albumin between the two groups (P < 0.05). Multivariate Logistic regression analysis showed that postoperative pain visual analogue score (OR=2.311,95%CI = 0.975 卤5.479), postoperative time of getting out of bed (OR=2.192,95%CI = 1.337 卤3.595) and triacylglycerol level (OR=2.160,95%CI = 1.427 卤5.319) were independent risk factors of omentum encapsulation after peritoneal dialysis tube operation (P < 0. 05). Conclusion after peritoneal dialysis tube placement, omentum encapsulation mostly occurs within 2 weeks after operation. Visual analogue score of postoperative pain, time of getting out of bed and level of triglyceride are independent risk factors for the occurrence of greater omentum encapsulation of peritoneal dialysis tube.
【作者单位】： 上海长海医院肾内科;
【基金】：国家自然科学基金资助项目(81500583)
【分类号】：R692
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