Ionescu Camelia, Ecobici Monica, Olaru Dana, Stănescu C, Lupescu Ioana, Voiculescu M
Center of Internal Medicine-Nephrology, Fundeni Clinical Institute, Bucharest, Romania.
Rom J Intern Med. 2008;46(4):351-5.
Peritoneal dialysis (PD) is the first option for patients in end stage renal disease (ESRD). Several complications such as peritonitis, exit-site or tunnels infections are encountered during PD. Other complications such as pain, proteic malnutrition, hyperglycemia, hypertension, cardiac failure are described in patients on continuous ambulatory peritoneal dialysis (CAPD) or APD (automated peritoneal dialysis). Rare complications are incapsulated sclerosing peritonitis, hemoperitoneum or pneumoperitoneum. We present the case of a female patient, 66 years old, on cyclic continuous peritoneal dialysis (APD-CCPD) admitted for pneumoperitoneum developed during a dialysis change from a CCPD schedule, due to an error in the Tenckhoff catheter and peritoneal dialysis manipulation. The treatment consisted in extracting the air during manual peritoneal dialysis changes, with the patient in Trendelenburg position and pressing on the abdominal wall, without any other complications.
腹膜透析(PD)是终末期肾病(ESRD)患者的首选治疗方式。在腹膜透析过程中会出现多种并发症,如腹膜炎、出口处或隧道感染。持续非卧床腹膜透析(CAPD)或自动化腹膜透析(APD)患者还会出现其他并发症,如疼痛、蛋白质营养不良、高血糖、高血压、心力衰竭等。罕见并发症有包裹性硬化性腹膜炎、腹腔积血或气腹。我们报告一例66岁女性患者,因在从持续循环腹膜透析(APD-CCPD)方案转换透析时发生气腹而入院,原因是Tenckhoff导管及腹膜透析操作失误。治疗方法是在手动更换腹膜透析液时抽出气体,患者取头低脚高位并按压腹壁,未出现其他并发症。