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包裹性腹膜硬化:问题解答

Encapsulating peritoneal sclerosis: Your questions answered.

作者信息

Pepereke Shingai, Shah Ankur D, Brown Edwina A

机构信息

Imperial College Renal and Transplant Centre, Hammersmith Hospital, London, UK.

Division of Kidney Disease and Hypertension, Department of Medicine, Rhode Island Hospital, Providence, RI, USA.

出版信息

Perit Dial Int. 2023 Mar;43(2):119-127. doi: 10.1177/08968608221125606. Epub 2022 Oct 2.

Abstract

Encapsulating peritoneal sclerosis (EPS) is a clinical syndrome hallmarked by the formation of a fibrous cocoon encapsulating the bowel resulting in morbidity and mortality. EPS is most frequently associated with peritoneal dialysis (PD), particularly with its discontinuation. While EPS is one of the most feared complications of PD, the majority of patients receiving PD will not go on to develop EPS. Risk factors for development include time on PD, some types of peritonitis and discontinuation of PD. Owing to its rarity, much of the knowledge of EPS comes from case series and registries and treatments are extrapolated from low-quality evidence. Malnutrition is a significant driver of mortality, and nutritional support is critical in management. We present a case of EPS and frequently asked questions including the definition, diagnosis, epidemiology, pathophysiology, risk factors, role of infection, management and roles of nutrition and surgery.

摘要

包裹性腹膜硬化症(EPS)是一种临床综合征,其特征是形成包裹肠道的纤维性茧,导致发病和死亡。EPS最常与腹膜透析(PD)相关,尤其是在其停止时。虽然EPS是PD最可怕的并发症之一,但大多数接受PD的患者不会发展为EPS。发病的风险因素包括腹膜透析时间、某些类型的腹膜炎和腹膜透析的停止。由于其罕见性,关于EPS的许多知识来自病例系列和登记处,治疗方法是从低质量证据中推断出来的。营养不良是死亡率的一个重要驱动因素,营养支持在管理中至关重要。我们介绍了一例EPS病例以及常见问题,包括定义、诊断、流行病学、病理生理学、风险因素、感染的作用、管理以及营养和手术的作用。

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