腹膜透析の新しい導入法　　“Ｍｏｎｃｒｉｅｆ　ａｎｄ　Ｐｏｐｏｖｉｃｈのカテーテル挿入法”を用いた段階的導入

DOI 被引用文献6件 参考文献13件

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  • Stepwise initiation of peritoneal dialysis using the Moncrief and Popovich technique.

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To reduce catheter-related infection in peritoneal dialysis patients, Moncrief and Popovich developed a new technique of catheter implantation. Briefly, the catheter was surgically implanted and its end was left embedded in subcutaneous tissue. A few weeks after implantation, the embedded subcutaneous catheter was exteriorized, and peritoneal dialysis was commenced. Using this technique, 17 catheters were implanted for stepwise initiation of peritoneal dialysis. Exteriorization was performed 27.4±17.1 (8-64) days after implantation of the catheter. Duration of hospitalization was 4.5±1.1 (3-6) days for catheter implantation, and 2.3±2.4 (0-6) days for exteriorization. Peritoneal dialysis commenced on the day of exteriorization with an exchange volume of 1.85±0.26L using 4 exchanges daily. One catheter was wrapped in omentum at catheter exteriorization. Total observation period after initiation of peritoneal dialysis was 127 patient months. During that period, there was no exit-site or tunnel infection except for one case of peritonitis. None of the patients experienced a dialysate leak. The stepwise initiation of peritoneal dialysis using the Moncrief and Popovich technique (SMAP) had some advantages not only regarding catheter infection and dialysate leakage, but also regarding quick commencement of peritoneal dialysis, quality of life and shortening the hospitalization period for the patient.

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