Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea.
Korean J Intern Med. 2013 Sep;28(5):587-93. doi: 10.3904/kjim.2013.28.5.587. Epub 2013 Aug 14.
BACKGROUND/AIMS: Encapsulating peritoneal sclerosis (EPS) is an often-fatal complication of long-term peritoneal dialysis (PD). We here report the clinical features of EPS in Korean PD patients from a single university center.
The data were collected retrospectively from 606 PD patients at Kyungpook National University Hospital, between August 2001 and August 2011. The diagnosis of EPS was based on clinical signs and symptoms, and confirmed by radiological findings.
Eight patients (1.3%, four males) were diagnosed with EPS. The mean age of the patients was 48.5 years (range, 33 to 65). The mean duration of PD was 111.8 months (range, 23 to 186). All patients except for one had three or more episodes of peritonitis. Seven patients were diagnosed with EPS after stopping PD, and only one stayed on PD after initial diagnosis and treatment. Total parenteral nutrition and corticosteroids, in addition to tamoxifen therapy, were used to treat most of the patients, and one patient underwent surgery (adhesiolysis). The overall mortality rate was 50%.
EPS is a serious, life-threatening complication in patients on long-term PD. To reduce the incidence and mortality rate of EPS, careful monitoring and early diagnosis is needed.
背景/目的:包裹性腹膜硬化症(EPS)是长期腹膜透析(PD)的一种常见致命并发症。我们在此报告了来自单个大学中心的韩国 PD 患者的 EPS 临床特征。
数据是从 2001 年 8 月至 2011 年 8 月在庆北国立大学医院的 606 名 PD 患者中回顾性收集的。根据临床症状和体征,结合影像学发现诊断 EPS。
8 名患者(1.3%,4 名男性)被诊断为 EPS。患者的平均年龄为 48.5 岁(范围,33 至 65 岁)。PD 的平均持续时间为 111.8 个月(范围,23 至 186 个月)。除了 1 名患者外,所有患者均有 3 次或以上腹膜炎发作。7 名患者在停止 PD 后被诊断为 EPS,只有 1 名患者在初始诊断和治疗后仍继续 PD。除了他莫昔芬治疗外,大多数患者还接受了肠外营养和皮质类固醇治疗,1 名患者接受了手术(粘连松解术)。总的死亡率为 50%。
EPS 是长期 PD 患者严重的、危及生命的并发症。为了降低 EPS 的发生率和死亡率,需要进行仔细的监测和早期诊断。