中文摘要：

目的探讨腹膜透析管安置术后患者发生腹膜透析管大网膜包裹的危险因素。方法选取2007年1月一2015年12月间在上海长海医院肾内科行常规腹膜透析管安置术的患者626例，其中术后发生大网膜包裹导致引流不畅29例（包裹组），未发生大网膜包裹597例（对照组）。对两组患者的临床资料进行比较，采用Logistic多元回归分析腹膜透析管安置术后大网膜包裹发生的危险因素。结果包裹组中，术后当天发生大网膜包裹2例，术后1～5d发生大网膜包裹4例，术后6～10d发生大网膜包裹10例，术后11～15d发生大网膜包裹10例，〉术后15d发生大网膜包裹3例。包裹组的BMI、身高和甲状旁腺激素水平均显著低于对照组（P值均〈o．05），便秘患者构成比、术后疼痛视觉模拟评分均显著高于对照组（P值均〈0．05），术后下床活动时间（手术结束至患者首次下床活动的时间）显著晚于对照组（P〈0．05），血钾、三酰甘油和胆固醇水平均显著高于对照组（P值均〈O．05）；两组间切口至耻骨联合距离和血红蛋白、血钙、血清铁、血磷、血清肌酐、白蛋白水平的差异均无统计学意义（P值均〉0．05）。多因素Logistic回归分析显示，术后疼痛视觉模拟评分（0R=2．311，95％CI为0．975～5．479）、术后下床活动时间（0R=2．192，95％CI为1．337～3．595）和三酰甘油水平（OR=2．160，95％CI为1．427～5．319）是腹膜透析管术后大网膜包裹发生的独立危险因素（P值均〈0．05）。结论腹膜透析管安置术后大网膜包裹多发生于术后2周以内，术后疼痛视觉模拟评分、下床活动时间和三酰甘油水平是发生腹膜透析管大网膜包裹的独立危险因素。

英文摘要：

Objective To investigate the risk factors of peritoneal dialysis tube wrapping after dialysis tube placement, Methods A total of 626 patients undergoing conventional peritoneal dialysis tube placement in the department of nephrology of Changhai Hospital between January 2007 and December 2015 were collected in this study. Postoperative omental wrapping led to inadequate drainage in 29 patients （package group）, while no omental wrapping happened in the other 597 patients （control group）. Logistic regression analysis was used to explore the risk factors of omental wrapping after peritoneal dialysis tube placement. Results In the package group, omental wrapping occurred in 2 cases on day 1, in 4 cases on day 1 to 5, in 10 cases on day 6 to 10, in 10 cases on day 11 to 15, and in 3 cases on day 15 after tube placement. The body mass index （BMI）, height and parathyroid hormone （PTH） levels of package group were significantly lower than those of control group （all P〈 0.05）. The constituent ratio of patients with constipation and postoperative pain scores of- package group were significantly higher than those of control group （both P〈0.05）. The ambulation time （the first-time ambulation after tube placement） of package group was significantly longer than that of control group （P 〈 0.05）. Serum potassium, triglyceride and cholesterol levels of package group were significantly higher than those of control group （P 〈 0. 05）. But there were no significant differences in terms of the distance between the incision and thesymphysis pubis, or the levels of hemoglobin, serum calcium, iron, phosphorus, creatinine, albumin between the two groups （all P〈0.05）. Multivariate Logistic regression analysis showed that postoperative pain score （OR = 2.311, 95% CI 0. 975- 5. 479）, ambulation time （OFt = 2. 192, 95% CI 1. 337- 3. 595） and triglyceride level （ OR = 2. 160, 95% CI 1. 427 - 5.319） were independent risk factors of omental wrapping after peritoneal dialysis （all P ?