国际医药卫生导报2025，Vol.31Issue(3)：400-405,6.DOI:10.3760/cma.j.cn441417-20240709-03010
复杂性先天性心脏病术后腹膜透析导管堵塞的危险因素分析
Risk factors for peritoneal dialysis catheter blockage after operation for complex congenital heart disease
摘要
Abstract
Objective To analyze the risk factors for peritoneal dialysis(PD)catheter blockage after operation for complex congenital heart disease and construct a prediction model,so as to provide reference for smooth implementation of PD after operation for complex congenital heart disease.Methods A prospective study was conducted,and 120 children who underwent PD after operation for complex congenital heart disease in Fuwai Central China Cardiovascular Hospital from December 2022 to February 2024 were selected as the research subjects.Among them,there were 82 boys and 38 girls,aged 6 months-3 years.There were 52 cases of tetralogy of Fallot,37 cases of transposition of the great arteries,28 cases of ventricular septal defects,and 3 other cases.All the children received PD treatment.The incidence of PD catheter blockage was analyzed,and the children were divided into a catheter blockage group(81 cases)and a non-catheter blockage group(39 cases)according to the presence/absence of catheter blockage.Univariate and multivariate logistic regression analysis were performed to identify the risk factors for PD catheter blockage after operation for complex congenital heart disease.A prediction model was constructed,and the predictive value of the prediction model was evaluated by the receiver operating characteristic curve(ROC).x2 test and t test were used for statistical analysis.Results In this study,81 children experienced catheter blockage after the first PD,with an incidence rate of 67.50％(81/120).The proportions of children under 1 year old,children undergoing catheterization at the right rectus abdominis,children with catheter displacement,children with twisted catheter,children without preventive medication during PD,and children with greater omentum wrapping in the catheter blockage group were higher than those in the non-catheter blockage group[85.19％(69/81)vs.58.97％(23/39),72.84％(59/81)vs.25.64％(10/39),32.10％(26/81)vs.12.82％(5/39),35.80％(29/81)vs.15.38％(6/39),69.14％(56/81)vs.23.08％(9/39),40.74％(33/81)vs.20.51％(8/39)],with statistically significant differences(all P＜0.05).Logistic regression analysis showed that catheter displacement(odds ratio=1.670,95％confidence interval 1.079-2.586),twisted catheter(odds ratio=1.642,95％confidence interval 1.219-2.212),and greater omentum wrapping(odds ratio=1.592,95％confidence interval 1.208-2.099)were the risk factors for PD catheter blockage after operation for complex congenital heart disease,and preventive medication during PD was a protective factor(odds ratio=0.676,95％confidence interval 0.536-0.852).According to the logistic regression analysis results,a prediction model was constructed.ROC analysis results showed that the sensitivity,specificity,area under the curve(AUC),and Youden index of the model were 84.62％,79.69％,0.865,and 0.643.Compared with the actual value,the accordance rate of the model was 95.00％[(78+36)/120].Conclusions There are multiple risk factors for PD catheter blockage after operation for complex congenital heart disease,including catheter displacement,twisted catheter,greater omentum wrapping,and preventive medication during PD.The prediction model constructed based on these factors helps to early identify the risk of catheter blockage,which is expected to provide reference for smooth implementation of PD after operation for complex congenital heart disease.关键词
腹膜透析/复杂性先天性心脏病/导管堵塞/危险因素/预测模型/儿童Key words
Peritoneal dialysis/Complex congenital heart disease/Catheter blockage/Risk factors/Prediction model/Children引用本文复制引用
李晨晨,王海燕,张媛媛,庞秋贺..复杂性先天性心脏病术后腹膜透析导管堵塞的危险因素分析[J].国际医药卫生导报,2025,31(3):400-405,6.基金项目
河南省医学科技攻关计划(LHGJ20220135) Henan Province Medical Science and Technology Research Plan(LHGJ20220135) （LHGJ20220135）
