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[Placement of peritoneal catheters with the assistance of X-ray fluoroscopy].

Research paper by Meichu M Cheng, Xiao X Fu, Junxiang J Chen, Jun J Li, Fuyou F Liu, Xun X Zhou

Indexed on: 03 Jan '13Published on: 03 Jan '13Published in: Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences



Abstract

To evaluate the value of X-ray fluoroscopy in preventing catheter dysfunction during catheterization of peritoneal dialysis.A total of 168 patients with end-stage renal failure were nonrandomized into group A (the conventional catheterization group) and group B (the conventional catheterization + bedside fluoroscopy group). All patients were followed up for 1 year after the catheterization. Details of the patients' general information, catheter-related complications and incidence of catheter dysfunction were analyzed.Hemorrhagic complications occurred in 9 patients (5.36%), including 2 incision hematomas, 4 bloody fluid drainages, 1 bladder perforation and 1 intestinal perforation (1.20%). Dialysate leakages occurred in 4 patients (2.38%): 2 right pleural effusion and 2 scrotal edemas. Infection-related complications (2.98%) in 5 patients were observed: 1 infectious peritonitis and 4 catheter exit infections. All peritoneal dialysis-related infections were cured after the treatment. There was no significant difference in the incidence of mechanical and infectious complications between the two groups (P> 0.05). No immediate catheter dysfunction was found in all patients, but late catheter dysfunction was observed in 14 patients (8.33%), including 9 catheter migrations (5.36%), 5 of which were induced by other reasons (2.98%). Catheter dysfunction in 11 out of the 14 patients occurred within 30 days post-catheterization, whereas 2 occurred over 30 days (caused by constipation). In group A, 12 patients developed delayed catheter dysfunction (11.65%), 10 of which (83.33%) were induced by catheter migration and the other 2 by other reasons. In group B, 2 (11.65%) delayed catheter dysfunctions were observed, including 1 catheter migration and 1 constipation. The incidence of catheter dysfunction in group A was significantly higher than that in group B (P<0.05). The success rate of catheterization in group B was 91.3%.Catheter dysfunction is a common complication in peritoneal dialysis. X-ray fluoroscopy during catheter insertion helps to monitor the location of the catheter, which can effectively prevent late catheter dysfunction and increase the success of catheterization in peritoneal dialysis.