【摘要】目的探讨垂直律动改善导管移位相关腹膜透析液引流障碍的临床效果。方法选取2017 年5 月～2019 年5 月上海交通大学附属第一人民医院肾内科收治的规律腹膜透析(peritoneal dialysis，PD)伴引流障碍患者，行立位腹部平片确诊为PD 导管移位22 例，利用垂直律动仪的高频低振幅振动治疗，记录治疗疗程及前后患者24h 超滤量，评估腹膜透析液引流速度，并复查腹部平片判断导管复位情况。结果22 例PD 导管移位患者中，垂直律动治疗后腹膜透析液引流速度较前平均增快59.317ml/min [(80.284 ± 26.079)ml/min 比(20.931±7.366)ml/min，t=10.656，P＜0.001]；其中3 例患者导管复位至真骨盆；17 例患者导管末端位置下降1～2 个椎体水平，2 例患者透析液引流障碍未改善。结论垂直律动治疗操作简单，能有效改善导管移位相关透析液引流障碍，值得在临床上推广应用。

【Abstract】Objective To investigate the clinical effect of vertical rhythm on ameliorating dialysate drainage disorder due to catheter displacement in peritoneal dialysis (PD) patients. Methods A total of 22 PD patients treated in the Department of Nephrology, the First Affiliated Hospital of Shanghai Jiaotong University from May 2017 to May 2019 were recruited. These patients complied with the diagnosis of drainage barrier due to PD catheter displacement confirmed by stand abdominal X-ray plain film. We used the vertical rhythm instrument with high frequency and low amplitude vibration to treat the patients. Their 24-hour ultrafiltration volume before and after the treatment was recorded, PD fluid drainage speed was assessed, and the
place of PD catheters was rEexamined by abdominal X-ray plain film. Results Among the 22 PD patients with catheter displacement, the average drainage rate of the outflow fluid increased by 59.317ml/min (80.284±26.079ml/min vs. 20.931± 7.366ml/min (t=10.656, P＜0.001) after vertical rhythm treatment. The place of PD catheters restored to the true pelvis in 3 cases; the tips of PD catheters moved down 1-2 vertebra levels in 17 cases and the drainage disorder remained in 2 cases. Conclusion The vertical rhythm therapy is simple to operate and can effectively improve the obstruction of dialysis fluid drainage caused by catheter displacement. This method is worthy of clinical use.