von Lilien T, Salusky I B, Yap H K, Fonkalsrud E W, Fine R N
Division of Pediatric Nephrology, UCLA School of Medicine.
Am J Kidney Dis. 1987 Nov;10(5):356-60. doi: 10.1016/s0272-6386(87)80101-4.
The course of 93 children, treated with continuous ambulatory peritoneal dialysis (CAPD) and continuous cycling peritoneal dialysis (CCPD) over a total of 1,819 months, was evaluated retrospectively regarding hernia development. Thirty-seven patients (40%) developed 60 hernias (one per 30 patient-months), of which 36 were ventral, 7 umbilical, 14 inguinal, and 3 scrotal. Hernia occurrence was inversely correlated to patient's age and duration of CAPD/CCPD. The rate of hernia development was highest within the first 3 months following initiation of CAPD/CCPD with a subsequent rapid decrease. The dialysate inflow volume was not related to hernia development. The only complication due to the presence of a hernia was one episode of incarceration of the small bowel that required immediate surgical intervention. Surgical repair was the treatment performed in 75% of the cases. The remaining hernias were managed with volume reduction, conversion from CAPD to CCPD, or discontinuation of the daytime dialysate dwell in patients undergoing CCPD. Our observations suggest that hernia development is a frequent complication in children treated with CAPD/CCPD.
对93名接受持续非卧床腹膜透析（CAPD）和持续循环腹膜透析（CCPD）治疗总计1819个月的儿童的病程进行回顾性评估，以了解疝气的发生情况。37名患者（40%）出现了60例疝气（每30患者 - 月1例），其中36例为腹疝，7例为脐疝，14例为腹股沟疝，3例为阴囊疝。疝气的发生与患者年龄及CAPD/CCPD的持续时间呈负相关。在开始CAPD/CCPD后的前3个月内，疝气发生率最高，随后迅速下降。透析液流入量与疝气发生无关。疝气唯一的并发症是1例小肠嵌顿，需要立即进行手术干预。75%的病例进行了手术修复。其余疝气通过减少容量、从CAPD转换为CCPD或在接受CCPD的患者中停止白天的透析液驻留来处理。我们的观察结果表明，疝气是接受CAPD/CCPD治疗的儿童中常见的并发症。
