Lee Pei-Hsien, Lin Chun-Liang, Lai Ping-Chin, Yang Chih-Wei
Department of Nephrology, Chang Gung Memorial Hospital, Chiaiy, Taiwan.
Nephrology (Carlton). 2005 Aug;10(4):344-7. doi: 10.1111/j.1440-1797.2005.00427.x.
Chylous ascites, a rare complication in patients receiving continuous peritoneal dialysis, often presents with turbid dialysate. This characteristic makes it frequently confused with peritonitis. Conservative treatments including bowel rest and dietary intervention with medium chain triglycerides are advised by many authors in the literature. However, this approach usually takes a long time before the lymphorrhagia are eventually resolved. Here, a case of chylous ascites that was successfully treated with subcutaneous octreotide, a somatostatin analogue, is reported. By shortening the bowel rest period, this treatment avoids the nutritional and immunological adverse effects. A series of peritoneal equilibrium tests were performed after administration of octreotide and the results showed that octreotide did not alter the peritoneal function in the short term. Therefore, subcutaneous octreotide administration is a safe and effective therapy in peritoneal dialysis patient with chylous ascites.
乳糜性腹水是接受持续性腹膜透析患者的一种罕见并发症,常表现为透析液浑浊。这一特征使其常与腹膜炎相混淆。文献中的许多作者建议采用包括肠道休息和中链甘油三酯饮食干预在内的保守治疗方法。然而,这种方法通常需要很长时间才能最终解决淋巴渗漏问题。在此,报告一例成功使用生长抑素类似物皮下注射奥曲肽治疗的乳糜性腹水病例。通过缩短肠道休息时间,这种治疗避免了营养和免疫方面的不良反应。在给予奥曲肽后进行了一系列腹膜平衡试验,结果表明奥曲肽在短期内不会改变腹膜功能。因此,皮下注射奥曲肽对腹膜透析合并乳糜性腹水的患者是一种安全有效的治疗方法。