持续性不卧床腹膜透析合并腹茧症的诊治

Diagnosis and treatment of patients with continuous ambulatory peritoneal dialysis combined with abdominal cocoon

目的：探讨持续性不卧床腹膜透析（continuous ambulatory peritoneal dialysis,CAPD）合并腹茧症患者的诊断及治疗方法。方法：回顾分析14例CAPD并发腹茧症患者的临床资料。结果：14例腹茧症均经手术或腹腔镜探查确诊。腹腔镜探查时患者无死亡病例及并发症发生,术后发生并发症5例,死亡1例。随访2-10年,6例患者死于尿毒症及合并症,3例反复发作不完全性肠梗阻,均经非手术治疗痊愈。结论：CAPD并发腹茧症术前诊断困难,影像学检查及腹腔镜探查有助于明确诊断。手术并发症及死亡率较高,手术松解、解除梗阻是有效的治疗手段。

Objective： To explore the diagnosis and treatmant for patients with continuous ambulatory peritoneal dialysis （CAPD） combined with abdominal cocoon. Methods：The clinical data of 14 cases of CAPD combined with abdominal cocoon were analyzed retrospectively. Results ： Fourteen cases with abdominal cocoon were diagnosed by operation and laparoscopy. The patients hadn＇t complications and death with laparoscopy. Postoperation complications were found in 5 cases and one case died. The cases were followed up for 2-10 years. Six cases died from uremia and complications,3 cases underwent repeatedly incomplete intestinal obstruction and recover by non-operative treatment. Conclusions：There are difficulties in diagnosing CAPD combined with abdominal cocoon before operation, but the imaging and laparoscopy are helpful to diagnose. The incidence of operative complications and mortality are higher, but operative lysis and ohstruction relieving are effective methods.