腹膜透析相关性腹膜炎诊治的临床决策

Clinical Strategy for the Diagnosis and Treatment of Peritoneal Dialysis-related Peritonitis

腹膜透析相关性腹膜炎的治疗以前主要着眼于抗生素的选择,但其防治应该是从腹透管置管开始的整体策略,包括预防性抗生素的使用、患者的强化培训、腹膜炎的早期快速诊断、给药途径与疗程,以及拔管指征等。肾科医师临床决策是需要根据最新的治疗指南及研究进展,结合患者的个体特点进行综合判断,以期达到最佳的治疗效果。

Treatment of peritoneal dialysis--related peritonitis previously focused mainly on the choice of antibiotics, but now it is recognized that the overall strategy of its prevention and treatment should start from the beginning of the peritoneal dialysis catheter insertion. It includes the use of prophylactic antibiotics, patients intensified training, rapid diagnosis of early infection, means of drug delivery and the indications for catheter removal. Clinical decision-making need refer to the latest guidelines and research, combined with the individual characteristics of patients, in order to achieve the best therapeutic effect.