Fischbach M, Terzic J, Laugel V, Escande B, Dangelser Cl, Helmstetter A
Nephrology Dialysis Transplantation Children's Unit, Hôpitaux Universitaires, 67098 Strasbourg, France.
Pediatr Nephrol. 2003 Oct;18(10):976-80. doi: 10.1007/s00467-003-1199-9. Epub 2003 Jul 26.
The prescription of peritoneal dialysis should be individualized based on parameters of tolerance and adequacy. Determination of the intraperitoneal fill volume is essential for optimal patient care. Fill volume enhancement is a factor of exchange surface area recruitment: the wetted, contact peritoneal dialysis membrane. Nevertheless, fill volume enhancement can also lead to patient discomfort, with the potential risk of too high an intraperitoneal pressure (hernia, gastro-esophageal reflux). The perception of the individual patient is also a subjective parameter of fill volume tolerance assessment. In contrast, measurement of the hydrostatic intraperitoneal pressure (IPP, cmH(2)O) allows an objective approach to fill volume tolerance. From our clinical experience of more than 10 years of IPP measurements in child care, we can give a recommendation for normal values in children: less than 18 cm of water, usually between 5 and 15 cm, correlated to the intraperitoneal fill volume (naturally), but individually taking into account age, gender, "accustomization" and overall body mass index.
腹膜透析的处方应根据耐受性和充分性参数进行个体化调整。确定腹腔填充量对于优化患者护理至关重要。填充量的增加是交换表面积增加的一个因素：湿润的、接触腹膜透析膜的面积。然而，填充量的增加也可能导致患者不适，存在腹腔内压力过高的潜在风险（疝气、胃食管反流）。个体患者的感受也是填充量耐受性评估的一个主观参数。相比之下，测量腹腔内静水压（IPP，厘米水柱）可以客观地评估填充量耐受性。根据我们在儿童护理中10多年的IPP测量临床经验，我们可以给出儿童正常数值的建议：小于18厘米水柱，通常在5至15厘米之间，与腹腔填充量相关（自然相关），但需单独考虑年龄、性别、“适应性”和总体体重指数。
