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PERİTON DİYALİZİNDE KATETER YERLEŞTİRME TEKNİĞİNİN KOMPLİKASYONLAR VE DİYALİZ ETKİNLİĞİ AÇISINDAN KARŞILAŞTIRILMASI

COMPARING CATHETER PLACEMENT TECHNIQUES BY COMPLICATIONS AND DIALYIS EFFICACY IN PERITONEAL DIALYSIS

Journal Name:

  • İstanbul Tıp Fakültesi Dergisi

Publication Year:

  • 2011

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Keywords (Original Language):

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Abstract (2. Language): 
Objective: Patients with end-stage renal disease (ESRD) require renal replacement treatment (RRT). Peritoneal dialysis (PD) is a modality of dialysis which involves a silicone tube inserted in the abdominal cavity, called the catheter, and with special solutions, called dialysate, administered to the abdominal cavity through the catheter. Peritoneal catheters may be introduced via surgical or percutaneous procedures. The present study aims to compare the complications and dialysis efficacy by catheter insertion methods in patients on PD being monitored in our polyclinic. Materials and methods: A total of 23 patients on PD, 11 males and 12 females, who had ESRD diagnosed for 41.4 ± 15 months, were included in this study. These patients were divided into two groups by the method of catheter insertion, e.g., via the laparoscopic surgery (group 1, n: 6) or percutaneously under local anesthesia (group 2, n: 13). Complications following the respective procedure in each group were compared and patients‟ Kt/V values were studied to determine dialysis efficacy. No significant difference was identified in dialysis efficacy (Kt/V) between the two catheter insertion methods (p>0.05). Results: There was an increased incidence of complications in the group of patients whose catheters were inserted via the surgical procedure, although the two groups were matched in terms of accompanying diseases. Conclusion: This result suggests that PD catheter insertion can be performed conveniently by a nephrology clinic team with adequate training and experience and that this is a procedure with fewer complications, provided that the procedure is performed on well-selected patients.
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Abstract (Original Language): 
Amaç: Son dönem böbrek yetmezliği (SDBY) olan hastalar renal replasman tedavisine (RRT) ihtiyaç duyarlar. Periton Diyalizi (PD); karın boĢluğuna yerleĢtirilen, kateter adını verdiğimiz silikon bir tüp ve diyalizat denilen karın boĢluğuna verilen özel solüsyonlar aracılığı ile yapılan bir diyaliz yöntemidir. Periton kateterleri cerrahi veya perkütan yöntemlerle takılabilir. Biz bu çalıĢmada polikliniğimizde izlenen PD hastalarımızın periton kateteri takılma Ģekline göre komplikasyonlarını ve diyaliz etkinliğini karĢılaĢtırmayı amaçladık. Gereç ve yöntem: Bu çalıĢmada SDBY için hastalık süresi 41,4 ± 15 ay olan 11 kadın, 12 erkek toplam 23 PD hastası alındı. Hastalar cerrahi yolla laparoskopik olarak (grup 1, n: 6) ve lokal anestezi altında perkütan olarak (grup 2, n: 17) kateter takılan Ģeklinde iki gruba ayrıldı. Her iki grubun yapılan iĢlem sonrasındaki komplikasyonları karĢılaĢtırıldı ve diyaliz etkinliğini değerlendirmek için Kt/V „sine bakıldı. Bulgular: Kateter takım teknikleri arasında diyaliz etkinliği (Kt/V) açısından fark bulunmadı (p>0,05). YandaĢ hastalık açısından fark bulunmayan iki grup arasında cerrahi yolla takılan kateterlerde komplikasyon oranı daha yüksek bulunmuĢtur. Sonuç: Bu da bize hasta seçimi iyi yapıldığı taktirde, PD kateteri yerleĢtirmenin yeterli eğitim ve tecrübeye sahip olan nefroloji kliniği ekibi tarafından kolayca yapılabilecek ve daha az komplikasyona yol açacak bir iĢlem olabileceğini düĢündürmektedir.
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  • 3
43-45
  • Turkish

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