Lewis J, Abbott J, Crompton K, Fowler I, Smith B
Baxter Healthcare Ltd., Compton, Berks., UK.
Adv Perit Dial. 1992;8:306-12.
We reviewed peritonitis (P) experience of four UK units using single use Y (Freeline T.M., Baxter UK)(F) and Twinbag (Solo T.M., Baxter UK) (S) disconnect systems, which incorporate the 'Flush Before Fill' principle. We aim to show clinical achievements, in varying circumstances, in the light of previously published in vitro study results. Each unit recorded P data, i.e., rates, causative organisms, and recurrences (R) over a 12 month period (Sept 89-Aug 90). This data was then analysed by system, by unit and in total. Each unit had similar definitions for P and R, but had varying system selection criteria. Unit 1 had a fairly open criteria for F use, then became more selective at the same time as introducing S. In unit 2, F, and then S, were first choice systems for all (inc. blind diabetics). Unit 3 trains every pt. on non-disconnect System 2, then pt. choice determines if they are retained onto a disconnect system. Unit 4 had a more highly selected population. Results, expressed as episodes/patient month, were as follows: [table: see text] We conclude that it is possible to achieve a low incidence of P, especially that caused by S. epidermidis, particularly with S. It would seem the extent is related to pt. to system selection criteria. The effects of R and ES/TI need to be addressed.
我们回顾了英国四个单位使用一次性Y型（Freeline T.M.，百特英国公司）（F）和双袋型（Solo T.M.，百特英国公司）（S）断开系统的腹膜炎（P）经验，这些系统采用了“先冲洗后填充”原则。我们旨在根据先前发表的体外研究结果，展示在不同情况下的临床成果。每个单位记录了12个月期间（1989年9月至1990年8月）的P数据，即发生率、致病微生物和复发率（R）。然后按系统、单位和总体对这些数据进行分析。每个单位对P和R有相似的定义，但系统选择标准各不相同。单位1对F的使用标准相当宽松，在引入S的同时变得更加严格。在单位2，F然后是S是所有人（包括失明糖尿病患者）的首选系统。单位3对每个患者进行非断开系统2的培训，然后由患者选择决定是否继续使用断开系统。单位4的患者选择更为严格。结果以发作次数/患者月表示，如下所示：[表格：见原文]我们得出结论，有可能实现低P发生率，尤其是由表皮葡萄球菌引起的，特别是使用S时。似乎其程度与患者对系统的选择标准有关。R和ES/TI的影响需要进一步探讨。
