2010年腹膜透析相关感染指南关于腹膜炎治疗部分的解读

Interpretation on the part of peritonitis management in peritoneal dialysis-related infections recommendations(2010 update)

目的:腹膜炎是维持性腹膜透析(peritoneal dialysis,PD)患者的主要并发症,是腹膜透析技术失败的主要原因,重者将导致腹膜衰竭、甚至患者死亡。作者对2010年国际腹膜透析协会关于腹膜透析相关感染的治疗指南中腹膜炎的治疗部分进行解读,便于临床医师、药师在临床药物治疗中参考。方法:从腹膜透析相关性腹膜炎的诊断、初始经验治疗、后续治疗方面进行解读,详细介绍腹膜透析相关性腹膜炎的规范抗感染治疗。结果与结论:腹膜炎时的规范用药非常重要,不仅要尽早地合理选择适当的经验用药,还要选择用药途径、用药频率,以及后续根据药敏结果调整用药,从而促进患者腹膜炎的治愈以及腹膜功能的恢复。

Objective：Peritonitis remains a leading complication of peritoneal dialysis （PD）, and peritonitis is the major cause of technique failure in PD. Severe and prolonged peritonitis can lead to peritoneal membrane failure and even result in death. The article intends to interpret peritonitis management sections in ‘PD-related infections recommendations： 2010 update’ published by International Society for Peritoneal Dialysis （ISPD） so as to be referred by clinician and pharmacist.Methods： The recommendations on the diagnosis, initial experiential therapy and the further treatment in peritoneal dialysis-related peritonitis were interpreted, especially introducing normative anti-infection treatment of peritoneal dialysis-related peritonitis.Results and conclusion：The normative medication in PD-related peritonitis is very important. The treatment effects depend on not only the choice of the initial experiential therapy, but also the route and the frequency of administration, and the following adjustment of the medication due to the antimicrobial result.