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南京医科大学学报(自然科学版) 第45卷第11期
·1656 · Journal of Nanjing Medical University(Natural Sciences) 2025年11月
·临床研究·
胃镜活检钳复位技术在腹膜透析导管漂管中的应用
裴小华 ,高 飞 ,任海滨 ,崔洪青 ,钱玉珺 ,吴晶晶 3*
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南京医科大学第一附属医院老年肾科,江苏 南京 210029;江苏省卫生健康发展研究中心,江苏 南京 210029;
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南京医科大学第一附属医院肾内科,江苏 南京 210029
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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。
[关键词] 腹膜透析;导管漂管;终末期肾脏病;复位
[中图分类号] R586.9 [文献标志码] A [文章编号] 1007⁃4368(2025)11⁃1656⁃06
doi: 10.7655/NYDXBNSN250788
Application of gastroscope biopsy forceps repositioning technique in the drift management
of peritoneal dialysis catheters
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PEI Xiaohua ,GAO Fei ,REN Haibin ,CUI Hongqing ,QIAN Yujun ,WU Jingjing 3*
Department of Geriatric Nephrology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029;
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2 Jiangsu Health Development Research Center,Nanjing 210029;Department of Nephrology,the First Affiliated
Hospital of Nanjing Medical University,Nanjing 210029,China
[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.
[Key words] peritoneal dialysis;catheter drift;end stage kidney disease;repositioning
[J Nanjing Med Univ,2025,45(11):1656⁃1661]
[基金项目] 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)
通信作者(Corresponding author),E⁃mail: jingjingwu82@njmu.edu.cn(ORCID:0000⁃0002⁃7197⁃4465)
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