Gagnadoux M F, Hernandez M A, Broyer M, Vacant J, Royer P
Arch Fr Pediatr. 1977 Nov;34(9):860-75.
27 children, aged 7 months to 15 years, with terminal renal failure and no available vascular access, were treated with chronic peritoneal dialysis for 3 weeks to 9 months (mean 3 months). An indwelling silicon catheter fitted with a subcutaneous dacron felt cuff was used; the average catheter life time was 10 weeks (3 to 25 weeks). Control of uremia was satisfactory with mean serum urea decreasing from 2 to 1 g/l and creatinine from 130 mg/l to 60 mg/l after 48 hours of dialysis. No uremic complications occured. Total serum protein remained stable: mean: 62 g/l prior to treatment and 60 g/l after the treatment period. Hematocrit was higher than in hemodialysed children (17% versus 15%). Three children were directly transplanted without difficulty. However, some complications did occur. There were 27 episodes of catheter obstruction leading to 12 surgical interventions. 18 episodes of peritonitis (5% of total dialyses) occured in 12 patients, and two were lethal. The frequency of complications prohibits a recommendation of chronic peritoneal dialysis over hemodialysis in children; this technique however remains very helpful in those situations where vascular access is difficult.
27名年龄在7个月至15岁之间、患有终末期肾衰竭且没有可用血管通路的儿童，接受了3周至9个月（平均3个月）的慢性腹膜透析治疗。使用了带有皮下涤纶纤维袖套的留置硅导管；导管平均使用时长为10周（3至25周）。透析48小时后，尿毒症得到了满意的控制，平均血清尿素从2g/l降至1g/l，肌酐从130mg/l降至60mg/l。未出现尿毒症并发症。血清总蛋白保持稳定：治疗前平均为62g/l，治疗期后为60g/l。血细胞比容高于接受血液透析的儿童（分别为17%和15%）。3名儿童直接顺利接受了移植。然而，确实出现了一些并发症。发生了27次导管阻塞，导致12次外科手术干预。12名患者发生了18次腹膜炎（占总透析次数的5%），其中2例致死。并发症的发生率使得不建议在儿童中采用慢性腹膜透析而非血液透析；然而，在血管通路困难的情况下，这项技术仍然非常有用。
