CAPD并发腹膜炎若干问题的探讨(附30例临床分析)

Investigation of Several problems in Patients with Peritonitis During Continuous Ambulatory Peritoneal Dialysis: with clinical Analysis of 30 Cases.

对30例急性肾衰竭(ARF)和慢性肾衰竭(CRF)病人进行CAPD治疗,其中并腹膜炎20例次,腹膜炎的发生率由1983年前的1次/5.87病人月降至1983年后的1次/7.55病人月。有11/15例发生透析管梗阻。在15个腹膜炎者中还进行了腹膜溶质清除特性,蛋白丢失量,葡萄糖吸收量和水的超滤量(出入超量)的初步探讨。

Thirty patients with acute renal failure (ARF) and chronic renal failure (CRF) have been well treated with continuous ambulatory peritoneal dialysis(CAPD)in our hospital. This group consisted of 19 CRF patients (14 male and 5 female, mean age 37.3 years)and 11 ARF Patients (5 male and 6 female, mean age 32.2 years). There were 20 patient-times complicated with peritonitis. Of them, 13 patient-times were infectious peritonitis, and 7 were noninfectious. The incidence of peritonitis with patients on CAPD was 1/7.55patient-month after 1983. It reduced significantly as compared with the incidence of 1/5.87 before 1983. We have observed that incidence of peritonitis with ARF patients on CAPD were much lower than that of CRFs (P<0.01). And obstruction of catheter had occurcd to 11/15 cases(P<0.01). Transperitoneal solute clearance, loss of serum protein, absorption of glucose and ultrafiltration of body-water during CAPD performance, were well investigated at the group of 15 patients with peritonitis. The results were much significant as compared with those of the controls(P<0.05～0.01). With exception of Cca^(++), Ck^+, CNa^+, Cer, ete Clearance rates showed significant differences between the peritoneal group and the control group. Our experience suggests that CAPD is effective in the management of CRF and ARF; it is simple in installation, convenient in operation and may be suitable in the situation of our eountry; the investigation, mentioned above, is much significant as a guide for patients being treated with CAPD.