【摘要】目的探讨超声引导在经皮穿刺腹膜透析导管植入术中应用的可行性、安全性、具体方法和近中期效果。方法回顾性纳入23 例接受超声引导下经皮穿刺腹膜透析导管置入术患者。术中使用超声引导穿刺针穿入腹腔并引导导管到达目标位置。术后至少随访6 个月。观察超声影像对手术过程的显示效果，统计该手术的技术成功率、术中及术后并发症(出血、肠道损伤、导管移位、堵管、渗漏、网膜包裹、腹膜炎等)发生率以及腹膜透析导管的技术生存率。结果超声可清晰显示穿刺及置管过程，技术成功率达100.0%。导管移位1 例，保守治疗后复位，透析不充分改血液透析1 例，余无明显并发症。估算6 个月、12 个月、18 个月和24 个月的腹膜透析导管的技术生存率分别为100.0%、100.0%、100.0%、75.0%。结论研究初步显示该种超声引导下经皮穿刺腹膜透析导管置入术是一种安全、可行、微创的腹膜透析置管方法，具有良好的近中期效果。

【Abstract】Objective To investigate the feasibility, safety, method and effect of ultrasound-guided percutaneous insertion of peritoneal dialysis (PD) catheters. Method This retrospective study involved 23 patients who underwent ultrasound-guided percutaneous PD catheter insertion. Peritoneal puncture and the insertion of the PD catheter were guided by ultrasound. The patients were followed up for at least 6 months. The effect of ultrasonography to display the surgical procedure, technical success ratio, and incidence of complications including bleeding, intestinal injury, catheter displacement, blockage, leakage, encapsulation and peritonitis, and estimated technical survival rate of the PD catheters were evaluated. Results Ultrasonography could clearly display the surgical procedure. The technical success ratio was 100.0%. Catheter displacement occurred in one patient, and was corrected after conservative treatment. Change from PD to hemodialysis occurred in one case due to the poor dialysis adequacy. No other major complications were found. The estimated technical survival rates of the PD catheters at 6, 12, 18 and 24 months were 100.0%, 100.0%, 100.0% and 75.0%, respectively. Conclusions Ultrasound-guided percutaneous PD catheter insertion is a safe, feasible and minimal invasive method with better effects in short and medium terms.