Levy M, Balfe J W, Geary D F, Fryer-Keene S P, Bannatyne R M
Department of Paediatrics, Hospital for Sick Children, Ont., Canada.
Child Nephrol Urol. 1988;9(5):253-8.
The clinical aspects of peritonitis were reviewed in 83 patients treated with continuous ambulatory or continuous cyclic peritoneal dialysis between May 1978 and April 1988. Peritonitis occurred in 50 patients whose mean duration of dialysis was 17.8 months, but not in 33 patients with a mean duration of dialysis of 10.4 months. The mean time from starting dialysis to the first episode of peritonitis was 7.1 months. The peritonitis rate was lower for continuous cyclic than for continuous ambulatory peritoneal dialysis (1 episode per 12.9 vs. 1 episode per 8.1 patient months, respectively). In 39% of the episodes, gram stain of the dialysate was positive. The dialysate leukocyte count was higher in gram-negative than in gram-positive peritonitis. Seventy percent of the peritonitis episodes were gram positive, and Staphylococcus aureus was predominant. Only 1 of the 7 diapered infants had gram-negative organisms associated with peritonitis. Catheters were replaced in 48 cases, 26 because of infection. Sixty-nine percent of the patients were cured with antibiotic therapy alone. Although peritonitis was associated with a mortality rate of 1.2%, peritoneal dialysis remains the favored dialytic mode for children.
对1978年5月至1988年4月期间接受持续非卧床腹膜透析或持续循环腹膜透析治疗的83例患者的腹膜炎临床情况进行了回顾。50例患者发生腹膜炎，其平均透析时间为17.8个月，而33例平均透析时间为10.4个月的患者未发生腹膜炎。从开始透析到首次发生腹膜炎的平均时间为7.1个月。持续循环腹膜透析的腹膜炎发生率低于持续非卧床腹膜透析（分别为每12.9患者月1次发作和每8.1患者月1次发作）。在39%的发作中，透析液革兰氏染色呈阳性。革兰氏阴性腹膜炎的透析液白细胞计数高于革兰氏阳性腹膜炎。70%的腹膜炎发作是革兰氏阳性，金黄色葡萄球菌占主导。7例使用尿布的婴儿中只有1例有与腹膜炎相关的革兰氏阴性菌。48例患者更换了导管，26例是因为感染。69%的患者仅通过抗生素治疗治愈。尽管腹膜炎的死亡率为1.2%，但腹膜透析仍是儿童首选的透析方式。
