胃镜活检钳复位技术在腹膜透析导管漂管中的应用
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1南京医科大学第一附属医院老年肾科,江苏 南京 210029 ; 2.江苏省卫生健康发展研究中心,江苏 南京 210029 ; 3.南京医科大学第一附属医院肾内科,江苏 南京 210029

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R586.9

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江苏省卫生健康发展研究中心开放课题(202418);江苏省科教能力提升工程(ZDXYS202210);江苏省干部保健课题(BJ24006);江苏省科技智库计划(科技创新)项目(JSKX 0225057)


Application of gastroscope biopsy forceps repositioning technique in the drift management of peritoneal dialysis catheters
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1Department of Geriatric Nephrology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029 ; 2.Jiangsu Health Development Research Center,Nanjing 210029 ; 3.Department of Nephrology,the First AffiliatedHospital of Nanjing Medical University,Nanjing 210029 ,China

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    摘要:

    目的:评估胃镜活检钳复位技术在腹膜透析(peritoneal dialysis,PD)导管漂管中的有效性与安全性。方法:回顾性分析2014年1月—2024年12月在南京医科大学第一附属医院行PD导管漂管患者的临床资料,比较胃镜活检钳复位与保守复位、手术复位的技术成功率、操作时间、费用及并发症等。结果:共721例患者进行PD置管术,术后导管漂管17例,总发生率 2.36 %。漂管患者首先接受保守复位,成功率为11.76%(2/17)。1例患者要求行腹腔镜复位,成功率为100%(1/1),费用为3 000元。 其余14例均接受胃镜活检钳复位,成功率为85.71%(12/14),操作时间为(24.00±6.65)min,费用为130元。2例胃镜活检钳复位失败患者均为置管2年以上,后采用开放手术复位成功,操作时间为60 min,费用为400元。所有患者均未发生严重并发症,术后24 h内均恢复透析。结论:胃镜活检钳复位技术安全、经济、高效,为零辐射的无创治疗手段,适用于PD导管漂管的早期处理。

    Abstract:

    Objective:To evaluate the efficacy and safety of gastroscopic biopsy forceps repositioning technique in peritoneal dialysis (PD)catheter drift. Methods:A retrospective analysis was conducted on clinical characteristics of PD catheter drift patients in the First Affiliated Hospital of Nanjing Medical University from January 2014 to December 2024. The technical success rate,procedure durations,cost,and complicationswere compared between conservative treatment,gastroscopic biopsy forceps repositioning and surgery repositioning. Results:A total of 721 patients underwent PD catheter placement,and 17 cases had catheter driftafter the operation, with a total incidence of 2.36%. Patients with catheter drift initially received conservative treatment,which achieved a success rate of 11.76%(2 out of 17). One patient requested laparoscopic repositioning,which was 100% successful(1 out of 1)at a cost of 3 000 yuan. The remaining 14 patients underwent gastroscopic biopsy forceps repositioning,with a success rate of 85.71%(12 out of 14). The procedure time for this method was(24.00 ± 6.65)min,and the cost was 130 yuan. The two patients who failed gastroscopic biopsy forceps repositioning had a long history of catheter placement over two years. They subsequently underwent successful open surgical repositioning,with a procedure time of 60 min and a cost of 400 yuan. No severe complications occurred in any of the cases,and all patients resumed dialysis function within 24 h postoperatively. Conclusion:Gastroscopic biopsy forceps repositioning technique is a safe,cost-effective,efficient,and minimally invasive technique,with no radiation exposure,andissuitable for the early treatment of PD catheter drift.

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裴小华,高飞,任海滨,崔洪青,钱玉珺,吴晶晶.胃镜活检钳复位技术在腹膜透析导管漂管中的应用[J].南京医科大学学报(自然科学版),2025,45(11):1656-1661

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  • 收稿日期:2025-07-11
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  • 在线发布日期: 2025-11-12
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