腹膜透析患者包裹性腹膜硬化综合管理中国专家共识

Comprehensive management of encapsulating peritoneal sclerosis in peritoneal dialysis patients:chinese expert consensus

包裹性腹膜硬化(encapsulating peritoneal sclerosis,EPS)是长期腹膜透析(peritone-al dialysis,PD)患者少见的严重并发症,预后差,死亡率高。EPS是慢性、隐匿性发生的疾病,早期通常不易识别。临床表现为腹膜进行性纤维样增厚、硬化,导致肠包裹,继而出现部分或完全性肠梗阻。其发病机制尚不明确,早期发现并及时干预可有效阻止EPS的病情发展,需多学科联合治疗。在我国EPS尚未被广泛认识,尤其对于基层医院的医生,易致漏诊或误诊。为指导临床医生全面认识PD患者EPS的发病机制、临床特点以及防治策略,识别EPS危险因素,尽早诊断、治疗EPS以延缓其进展,由中国医院协会血液净化中心分会组织我国长期从事腹膜透析领域的专家制定此专家共识。

Encapsulation Peritoneal Sclerosis(EPS)is a rare and serious complication in long-term peritoneal dialysis patients,with poor prognosis and high mortality rate.EPS is a chronic and insidious disease that often difficult to identify in its early stages.It is characterized by progressive and extensive fibrotic thickening of the peritoneum,peritoneal sclerosis,which causes progressive obstruction and encapsulation of the bowel.Till now,the pathogenesis of EPS remains uncertain.Early detection and timely intervention can effectively prevent the progression of EPS,and multidisciplinary combination treatment is needed.However,EPS has not been widely recognized in China,especially for doctors in primary hospitals,which can easily lead to missed diagnosis or misdiagnosis.In order to guide physician to comprehensively understand the pathogenesis,clinical characteristics,and prevention and treatment strategies of EPS in peritoneal dialysis(PD)patients,identify EPS risk factors,diagnose and treat EPS early so as to delay its progression,the Blood Purification Center Branch of Chinese Hospital Association organized experts in the field of peritoneal dialysis in China to develop this expert consensus.