腹透導(dǎo)管技術(shù)并發(fā)癥(醫(yī)學(xué)講座培訓(xùn)課件)

腹膜透析導(dǎo)管技術(shù)的相關(guān)問(wèn)題主講人：XXX（醫(yī)學(xué)講座培訓(xùn)課件）腹膜透析導(dǎo)管技術(shù)的相關(guān)問(wèn)題主講人：XXX（醫(yī)學(xué)講座培訓(xùn)課件）腹膜透析導(dǎo)管種類(lèi)導(dǎo)管置入技術(shù)目前存在的問(wèn)題腹膜透析早期與晚期失敗的原因（醫(yī)學(xué)講座培訓(xùn)課件）腹膜透析導(dǎo)管種類(lèi)（醫(yī)學(xué)講座培訓(xùn)課件）由無(wú)毒的惰性材料制成,可彎曲,質(zhì)量穩(wěn)定具備高的光潔度,能夠有效避免微生物在其表面聚集而發(fā)生腹膜炎不透X線,便于影像學(xué)檢查不受體溫、透析液酸堿度、透析液成分及消毒劑的影響而發(fā)生質(zhì)量改變,以防止長(zhǎng)期使用過(guò)程中發(fā)生化學(xué)性腹膜炎和異物反應(yīng)導(dǎo)管應(yīng)在皮下和腹膜上兩個(gè)部位牢固地與組織結(jié)合,以有效防止漏液和皮下隧道感染具有良好的生物相容性,不易被大網(wǎng)膜包裹。理想的腹膜透析導(dǎo)管（醫(yī)學(xué)講座培訓(xùn)課件）由無(wú)毒的惰性材料制成,可彎曲,質(zhì)量穩(wěn)定理想的腹膜透析導(dǎo)管?Siliconerubber(nearlyallcatheters)?Polyurethane(Cruzcatheter)Twomainmaterials（醫(yī)學(xué)講座培訓(xùn)課件）?Siliconerubber(nearlyallTheMostCommonlyUsedCatheters,byInnerandOuterShaftShape（醫(yī)學(xué)講座培訓(xùn)課件）TheMostCommonlyUsedCathete（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）(A)Flex-NeckTenckhoffcatheter,silicone(Medigroup,Oswego,IL,U.S.A.);(B)CruzTenckhoffcatheter,polyurethane;(C)StandardTenckhoffcatheter,silicone;(D)OneintraperitoneallimboftheT-flutedcatheter(AshAdvantage:AshAdvantageTechnology,Lafayette,IN,U.S.A.),silicone.FromS.Ash,withpermission.2.6mm,thestandardsizeoftheTenckhoffcatheter,swan-neckcatheter,Missouriswan-neckcatheter,andTWHcatheter3.1mm(Cruzcatheter)3.5mm[Flex-Neck(Medigroup,Oswego,IL,U.S.A.)andAshAdvantagecatheters](A)Flex-NeckTenckhoffcathet（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）BMI>35（醫(yī)學(xué)講座培訓(xùn)課件）BMI>35（醫(yī)學(xué)講座培訓(xùn)課件）腹膜透析導(dǎo)管種類(lèi)導(dǎo)管置入技術(shù)目前存在的問(wèn)題腹膜透析早期與晚期失敗的原因（醫(yī)學(xué)講座培訓(xùn)課件）腹膜透析導(dǎo)管種類(lèi)（醫(yī)學(xué)講座培訓(xùn)課件）外科手術(shù)置管法腹腔鏡置管法X線透視下置管術(shù)導(dǎo)管置入技術(shù)外科手術(shù)置管法導(dǎo)管置入技術(shù)（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）腹膜透析導(dǎo)管種類(lèi)導(dǎo)管置入技術(shù)目前存在的問(wèn)題腹膜透析早期與晚期失敗的原因（醫(yī)學(xué)講座培訓(xùn)課件）腹膜透析導(dǎo)管種類(lèi)（醫(yī)學(xué)講座培訓(xùn)課件）PD置管過(guò)程中常見(jiàn)的并發(fā)癥內(nèi)臟損傷導(dǎo)管移位網(wǎng)膜包裹導(dǎo)管透析管出水不暢透析液滲漏疝腹膜炎及出口處感染麻醉意外（醫(yī)學(xué)講座培訓(xùn)課件）PD置管過(guò)程中常見(jiàn)的并發(fā)癥內(nèi)臟損傷（醫(yī)學(xué)講座培訓(xùn)課件）導(dǎo)管位置不良移位堵塞或包裹所致的腹膜透析液引流不暢腹膜透析液滲漏疝機(jī)械并發(fā)癥（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）導(dǎo)管位置不良機(jī)械并發(fā)癥（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件腹透導(dǎo)管技術(shù)并發(fā)癥(醫(yī)學(xué)講座培訓(xùn)課件)（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）Chronicperitonealdialysisinchildren:catheterrelatedcomplications.AsinglecentreexperiencePediatrSurgInt(2006)22:524–528（醫(yī)學(xué)講座培訓(xùn)課件）Chronicperitonealdialysisin（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）CausesofcatheterremovalCausesofcatheterremoval血脂代謝紊亂與腹膜透析置管大網(wǎng)膜包裹的關(guān)系中國(guó)血液凈化2008年3月第7卷第3期

選擇中南大學(xué)湘雅醫(yī)院腎內(nèi)科收集腹膜透析置管術(shù)后發(fā)生大網(wǎng)膜包裹病例15例，以同期未發(fā)生大網(wǎng)膜包裹病例30例為對(duì)照，對(duì)比二組發(fā)生血脂代謝紊亂的差異。同時(shí)，以是否存在血脂代謝紊亂分組，對(duì)比腹膜透析置管術(shù)后大網(wǎng)膜包裹的發(fā)生率。血脂代謝紊亂與腹膜透析置管大網(wǎng)膜包裹的關(guān)系中國(guó)血液凈化200腹透導(dǎo)管技術(shù)并發(fā)癥(醫(yī)學(xué)講座培訓(xùn)課件)（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）血脂代謝紊亂組20例，網(wǎng)膜包裹11例，網(wǎng)膜包裹率55%血脂代謝正常組25例，網(wǎng)膜包裹4例，網(wǎng)膜包裹率16%前者較后者顯著升高，P＜0.05，差異有統(tǒng)計(jì)學(xué)意義。按照有無(wú)血脂代謝紊亂分組比較網(wǎng)膜包裹發(fā)生情況（醫(yī)學(xué)講座培訓(xùn)課件）血脂代謝紊亂組20例，網(wǎng)膜包裹11例，網(wǎng)膜包裹率55%按照PATIENTCHARACTERISTICSASSOCIATEDWITHDEFECTSOFTHEPERITONEALCAVITYBOUNDARYPeritonealDialysisInternational,Vol.25,pp.367–373（醫(yī)學(xué)講座培訓(xùn)課件）PATIENTCHARACTERISTICSASSOCI（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）Othercomplicationsincludedpericatheterorsubcutaneousleak,hydrothorax,andmiscellaneous.（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）Othercomplicationsincludedp腹透導(dǎo)管技術(shù)并發(fā)癥(醫(yī)學(xué)講座培訓(xùn)課件)腹透導(dǎo)管技術(shù)并發(fā)癥(醫(yī)學(xué)講座培訓(xùn)課件)200ofthesepatientsexperiencedatotalof217anatomiccomplications16patientshadmorethan1complication.Herniascomprised60.4%ofallcomplications:24.9%inguinal,18.9%umbilical,13.8%ventral,2.3%femoral,and0.5%intrathoracic.Othercomplicationsincludedpericatheterorsubcutaneousleak(25.3%),hydrothorax(6.0%),andmiscellaneous(8.3%).PeritonealdialysismodalitiesinuseatthetimeofcomplicationwereautomatedPD(52.3%),continuousambulatoryPD(38.6%),andnocturnalintermittentPD(9.1%).Theoverallincidenceofherniaswas7%.（醫(yī)學(xué)講座培訓(xùn)課件）200ofthesepatientsexperien（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）腹透導(dǎo)管技術(shù)并發(fā)癥(醫(yī)學(xué)講座培訓(xùn)課件)腹膜透析導(dǎo)管種類(lèi)導(dǎo)管置入技術(shù)目前存在的問(wèn)題腹膜透析早期與晚期失敗的原因（醫(yī)學(xué)講座培訓(xùn)課件）腹膜透析導(dǎo)管種類(lèi)（醫(yī)學(xué)講座培訓(xùn)課件）CONTRIBUTIONOFEARLYFAILURETOOUTCOMEONPERITONEALDIALYSISPeritDialInt2008;28:259–267CONTRIBUTIONOFEARLYFAILUREToanalyzetheimportanceofearlytreatmentfailureinPDandtocompareearlywithlatefailureswithrespecttoreasonsandpredictorsofriskforfailure.（醫(yī)學(xué)講座培訓(xùn)課件）Toanalyzetheimportanceofe（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）EarlyfailureofPDisfrequentandmakesanimportantcontributiontooverallPDoutcome.Inourpopulation,onethirdofallPDfailuresand40%ofalltechniquefailuresoccurredwithinthefirst6monthsfollowingcatheterimplantation.IdentificationofthemaincausesofearlyPDfailure(catheterimplantation,psychosocialproblems)isthefirststeptoimprovingoutcomebyinterventions(e.g.,improvementofcatheterimplantationtechnique,supporttopreventpsychosocialproblems).EarlyfailureofPDisfrequen腹部和盆腔手術(shù)史對(duì)終末期腎病患者腹膜透析導(dǎo)管置管的影響有腹部和盆腔手術(shù)史(A)組25例無(wú)腹部和盆腔手術(shù)史(B)組86例其中A組具體手術(shù)如下:闌尾切除術(shù)7例、腎盂切開(kāi)取石術(shù)7例、膽囊切除術(shù)6例、輸卵管結(jié)扎術(shù)1例、剖宮產(chǎn)術(shù)2例、子宮切除術(shù)1例、胃大部切除術(shù)2例和脾臟切除術(shù)1例,其中2例曾接受2種手術(shù)治療。丁小強(qiáng)等內(nèi)科理論與實(shí)踐2007年第2卷第6期腹部和盆腔手術(shù)史對(duì)終末期腎病患者有腹部和盆腔手術(shù)史(A)組腹透導(dǎo)管技術(shù)并發(fā)癥(醫(yī)學(xué)講座培訓(xùn)課件)

對(duì)先前有腹部和盆腔手術(shù)史的ESRD患者,如腹部手術(shù)范圍較小、估計(jì)腹腔內(nèi)粘連較輕者,一般仍可選擇PD治療。既往腹部和盆腔手術(shù)史對(duì)ESRD患者PD導(dǎo)管放置后短期和長(zhǎng)期并發(fā)癥的發(fā)生率沒(méi)有顯著影響。對(duì)先前有腹部和盆腔手術(shù)史的ESRD患者,如腹部Tiong等分析了164例CAPD置管手術(shù)患者,結(jié)果發(fā)現(xiàn)43例先前有腹部手術(shù)史的患者中有18例(41.9%)置管術(shù)后出現(xiàn)短期(≤30d)并發(fā)癥(如傷口出血或感染、導(dǎo)管移位、出口處出血或感染、早期腹膜炎、管周腹透液滲漏等),而121例無(wú)腹部手術(shù)史的患者中只有32例(26.4%)置管術(shù)后出現(xiàn)短期(>30d)并發(fā)癥。作者認(rèn)為先前腹部手術(shù)史是CAPD短期并發(fā)癥的高危因素。TiongHY,etal.SingaporeMed,2006,47(8):707-711.（醫(yī)學(xué)講座培訓(xùn)課件）Tiong等分析了164例CAPD置管手術(shù)患者回顧性分析上海長(zhǎng)征醫(yī)院1999年～2008年由腹膜透析轉(zhuǎn)血液透析治療的39例患者①透析不充分：尿毒癥癥狀和體征無(wú)明顯改善和(或)血肌酐下降不明顯；②技術(shù)失敗：漂管、堵管、滲液；③感染：腹膜透析相關(guān)感染；④失超濾；⑤其他原因。（醫(yī)學(xué)講座培訓(xùn)課件）回顧性分析上海長(zhǎng)征醫(yī)院1999年～2008年由腹膜透析轉(zhuǎn)血液（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）小結(jié)1.腹膜透析導(dǎo)管的選擇對(duì)其預(yù)后很重要。2.開(kāi)放性手術(shù)置管術(shù)已經(jīng)很成熟，若條件允許可以進(jìn)一步探討腹腔鏡術(shù)式的使用。3.完善術(shù)后護(hù)理與教育是預(yù)后良好的保障。（醫(yī)學(xué)講座培訓(xùn)課件）小結(jié)1.腹膜透析導(dǎo)管的選擇對(duì)其預(yù)后很重要。謝謝（醫(yī)學(xué)講座培訓(xùn)課件）謝謝（醫(yī)學(xué)講座培訓(xùn)課件）腹膜透析導(dǎo)管技術(shù)的相關(guān)問(wèn)題主講人：XXX（醫(yī)學(xué)講座培訓(xùn)課件）腹膜透析導(dǎo)管技術(shù)的相關(guān)問(wèn)題主講人：XXX（醫(yī)學(xué)講座培訓(xùn)課件）腹膜透析導(dǎo)管種類(lèi)導(dǎo)管置入技術(shù)目前存在的問(wèn)題腹膜透析早期與晚期失敗的原因（醫(yī)學(xué)講座培訓(xùn)課件）腹膜透析導(dǎo)管種類(lèi)（醫(yī)學(xué)講座培訓(xùn)課件）由無(wú)毒的惰性材料制成,可彎曲,質(zhì)量穩(wěn)定具備高的光潔度,能夠有效避免微生物在其表面聚集而發(fā)生腹膜炎不透X線,便于影像學(xué)檢查不受體溫、透析液酸堿度、透析液成分及消毒劑的影響而發(fā)生質(zhì)量改變,以防止長(zhǎng)期使用過(guò)程中發(fā)生化學(xué)性腹膜炎和異物反應(yīng)導(dǎo)管應(yīng)在皮下和腹膜上兩個(gè)部位牢固地與組織結(jié)合,以有效防止漏液和皮下隧道感染具有良好的生物相容性,不易被大網(wǎng)膜包裹。理想的腹膜透析導(dǎo)管（醫(yī)學(xué)講座培訓(xùn)課件）由無(wú)毒的惰性材料制成,可彎曲,質(zhì)量穩(wěn)定理想的腹膜透析導(dǎo)管?Siliconerubber(nearlyallcatheters)?Polyurethane(Cruzcatheter)Twomainmaterials（醫(yī)學(xué)講座培訓(xùn)課件）?Siliconerubber(nearlyallTheMostCommonlyUsedCatheters,byInnerandOuterShaftShape（醫(yī)學(xué)講座培訓(xùn)課件）TheMostCommonlyUsedCathete（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）(A)Flex-NeckTenckhoffcatheter,silicone(Medigroup,Oswego,IL,U.S.A.);(B)CruzTenckhoffcatheter,polyurethane;(C)StandardTenckhoffcatheter,silicone;(D)OneintraperitoneallimboftheT-flutedcatheter(AshAdvantage:AshAdvantageTechnology,Lafayette,IN,U.S.A.),silicone.FromS.Ash,withpermission.2.6mm,thestandardsizeoftheTenckhoffcatheter,swan-neckcatheter,Missouriswan-neckcatheter,andTWHcatheter3.1mm(Cruzcatheter)3.5mm[Flex-Neck(Medigroup,Oswego,IL,U.S.A.)andAshAdvantagecatheters](A)Flex-NeckTenckhoffcathet（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）BMI>35（醫(yī)學(xué)講座培訓(xùn)課件）BMI>35（醫(yī)學(xué)講座培訓(xùn)課件）腹膜透析導(dǎo)管種類(lèi)導(dǎo)管置入技術(shù)目前存在的問(wèn)題腹膜透析早期與晚期失敗的原因（醫(yī)學(xué)講座培訓(xùn)課件）腹膜透析導(dǎo)管種類(lèi)（醫(yī)學(xué)講座培訓(xùn)課件）外科手術(shù)置管法腹腔鏡置管法X線透視下置管術(shù)導(dǎo)管置入技術(shù)外科手術(shù)置管法導(dǎo)管置入技術(shù)（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）腹膜透析導(dǎo)管種類(lèi)導(dǎo)管置入技術(shù)目前存在的問(wèn)題腹膜透析早期與晚期失敗的原因（醫(yī)學(xué)講座培訓(xùn)課件）腹膜透析導(dǎo)管種類(lèi)（醫(yī)學(xué)講座培訓(xùn)課件）PD置管過(guò)程中常見(jiàn)的并發(fā)癥內(nèi)臟損傷導(dǎo)管移位網(wǎng)膜包裹導(dǎo)管透析管出水不暢透析液滲漏疝腹膜炎及出口處感染麻醉意外（醫(yī)學(xué)講座培訓(xùn)課件）PD置管過(guò)程中常見(jiàn)的并發(fā)癥內(nèi)臟損傷（醫(yī)學(xué)講座培訓(xùn)課件）導(dǎo)管位置不良移位堵塞或包裹所致的腹膜透析液引流不暢腹膜透析液滲漏疝機(jī)械并發(fā)癥（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）導(dǎo)管位置不良機(jī)械并發(fā)癥（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件腹透導(dǎo)管技術(shù)并發(fā)癥(醫(yī)學(xué)講座培訓(xùn)課件)（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）Chronicperitonealdialysisinchildren:catheterrelatedcomplications.AsinglecentreexperiencePediatrSurgInt(2006)22:524–528（醫(yī)學(xué)講座培訓(xùn)課件）Chronicperitonealdialysisin（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）CausesofcatheterremovalCausesofcatheterremoval血脂代謝紊亂與腹膜透析置管大網(wǎng)膜包裹的關(guān)系中國(guó)血液凈化2008年3月第7卷第3期

選擇中南大學(xué)湘雅醫(yī)院腎內(nèi)科收集腹膜透析置管術(shù)后發(fā)生大網(wǎng)膜包裹病例15例，以同期未發(fā)生大網(wǎng)膜包裹病例30例為對(duì)照，對(duì)比二組發(fā)生血脂代謝紊亂的差異。同時(shí)，以是否存在血脂代謝紊亂分組，對(duì)比腹膜透析置管術(shù)后大網(wǎng)膜包裹的發(fā)生率。血脂代謝紊亂與腹膜透析置管大網(wǎng)膜包裹的關(guān)系中國(guó)血液凈化200腹透導(dǎo)管技術(shù)并發(fā)癥(醫(yī)學(xué)講座培訓(xùn)課件)（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）血脂代謝紊亂組20例，網(wǎng)膜包裹11例，網(wǎng)膜包裹率55%血脂代謝正常組25例，網(wǎng)膜包裹4例，網(wǎng)膜包裹率16%前者較后者顯著升高，P＜0.05，差異有統(tǒng)計(jì)學(xué)意義。按照有無(wú)血脂代謝紊亂分組比較網(wǎng)膜包裹發(fā)生情況（醫(yī)學(xué)講座培訓(xùn)課件）血脂代謝紊亂組20例，網(wǎng)膜包裹11例，網(wǎng)膜包裹率55%按照PATIENTCHARACTERISTICSASSOCIATEDWITHDEFECTSOFTHEPERITONEALCAVITYBOUNDARYPeritonealDialysisInternational,Vol.25,pp.367–373（醫(yī)學(xué)講座培訓(xùn)課件）PATIENTCHARACTERISTICSASSOCI（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）Othercomplicationsincludedpericatheterorsubcutaneousleak,hydrothorax,andmiscellaneous.（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）Othercomplicationsincludedp腹透導(dǎo)管技術(shù)并發(fā)癥(醫(yī)學(xué)講座培訓(xùn)課件)腹透導(dǎo)管技術(shù)并發(fā)癥(醫(yī)學(xué)講座培訓(xùn)課件)200ofthesepatientsexperiencedatotalof217anatomiccomplications16patientshadmorethan1complication.Herniascomprised60.4%ofallcomplications:24.9%inguinal,18.9%umbilical,13.8%ventral,2.3%femoral,and0.5%intrathoracic.Othercomplicationsincludedpericatheterorsubcutaneousleak(25.3%),hydrothorax(6.0%),andmiscellaneous(8.3%).PeritonealdialysismodalitiesinuseatthetimeofcomplicationwereautomatedPD(52.3%),continuousambulatoryPD(38.6%),andnocturnalintermittentPD(9.1%).Theoverallincidenceofherniaswas7%.（醫(yī)學(xué)講座培訓(xùn)課件）200ofthesepatientsexperien（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）腹透導(dǎo)管技術(shù)并發(fā)癥(醫(yī)學(xué)講座培訓(xùn)課件)腹膜透析導(dǎo)管種類(lèi)導(dǎo)管置入技術(shù)目前存在的問(wèn)題腹膜透析早期與晚期失敗的原因（醫(yī)學(xué)講座培訓(xùn)課件）腹膜透析導(dǎo)管種類(lèi)（醫(yī)學(xué)講座培訓(xùn)課件）CONTRIBUTIONOFEARLYFAILURETOOUTCOMEONPERITONEALDIALYSISPeritDialInt2008;28:259–267CONTRIBUTIONOFEARLYFAILUREToanalyzetheimportanceofearlytreatmentfailureinPDandtocompareearlywithlatefailureswithrespecttoreasonsandpredictorsofriskforfailure.（醫(yī)學(xué)講座培訓(xùn)課件）Toanalyzetheimportanceofe（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）（醫(yī)學(xué)講座培訓(xùn)課件）EarlyfailureofPDisfrequentandmakesanimportantcontributiontooverallPDoutcome.Inourpopulation,onethirdofallPDfailuresand40%ofalltechniquefailuresoccurredwithinthefirst6monthsfollowingcatheterimplantation.IdentificationofthemaincausesofearlyPDfailure(catheterimplantation,psychosocialproblems)isthefirststeptoimprovingoutcomebyinterventions(e.g.,improvementofcatheterimplantationtechnique,supporttopreventpsychosocialproblems).EarlyfailureofPDisfrequen腹部和盆